A Critical Review of the Effects of Nicotine and Alcohol Coadministration in Human Laboratory Studies

Abstract

Simultaneous use of cigarettes and alcohol is common and may be driven by nicotine increasing alcohol self-administration or vice versa. To better evaluate the causal nature of this relationship, we systematically reviewed human experimental laboratory studies that coadministered nicotine and alcohol with control conditions. Searches of PubMed/MEDLINE and PsycINFO databases and study bibliographies identified 30 studies that met our inclusion criteria. Research methodologies were critically reviewed. Effects of coadministration on drug self-administration and related factors such as craving, subjective response, motivation, and heart rate are reported. Results most strongly supported that alcohol increases nicotine and cigarette self-administration, whereas, depending on the context, nicotine increased, decreased, or had no effect on alcohol self-administration. Craving and subjective drug effects were also impacted by coadministration. Interaction effects of nicotine and alcohol on self-administration and subjective responses were reported infrequently. The effects may be moderated by a number of factors, including dose of administered drug and sex. Recommendations are made for future research, and clinical and policy implications of findings are discussed.

Cigarette Use Among Individuals with Alcohol Use Disorders in the United States, 2002 to 2016: Trends Overall and by Race/Ethnicity

“…There are several potential pharmacological, genetic, and environmental reasons for these high levels of co-use and maintenance of smoking among people with AUDs (Adams, 2017; McKee and Weinberger, 2013; Roche et al, 2016). For example, alcohol increases craving for nicotine and nicotine self-administration (Dermody and Hendershot, 2017; Verplaetse and McKee, 2017). Treatment programs for AUDs may present an important opportunity to aid these individuals with smoking cessation efforts.…”

“…Although there may be concerns about providing smoking treatment concurrent with alcohol treatment, most studies find that concurrent smoking and alcohol treatment do not yield worse outcomes than treating alcohol alone (for recent reviews, see McKelvey et al, 2017; Thurgood et al, 2016). As cigarette use increases craving to use alcohol (Cooney et al, 2007; Dermody and Hendershot, 2017; Verplaetse and McKee, 2017), is related to decreased cognitive recovery in adults with AUDs (Durazzo et al, 2006, 2014; Pennington et al, 2013), and is associated with poorer AUD outcomes (Durazzo and Meyerhoff, 2017; Weinberger et al, 2015), combined smoking and alcohol treatment may offer significant benefits for alcohol treatment outcomes.…”

Cigarette smoking quit rates among adults with and without alcohol use disorders and heavy alcohol use, 2002–2015: A representative sample of the United States population

“…In fact, studies suggest greater cravings to use alcohol when smoking cigarettes (see Dermody and Hendershot, 2017 for a review) and smoking may be associated with poorer long-term AUD outcomes (e.g., Weinberger et al, 2015). Notably, some studies have found improved alcohol and drug outcomes when those in treatment for alcohol and substance use disorders are also treated for tobacco use (McKelvey et al, 2017; Thurgood et al, 2016).…”

Electronic Cigarette Use and Risk of Harmful Alcohol Consumption in the U.S. Population

“…Risk of harmful drinking is even higher among those who engage in nondaily tobacco use compared to daily tobacco use (McKee et al, 2007, Harrison et al, 2008). Preclinical and human laboratory studies indicate that tobacco use may increase risk of harmful drinking (Verplaetse and McKee, 2017, Dermody and Hendershot, 2017, Kohut, 2017). Tobacco potentiates the reinforcing effects of alcohol (Piasecki et al, 2011), which may explain the high rate of episodic co-administration among people who use both substances (McKee and Weinberger, 2013).…”