Clinical Correlates of Cigarette Smoking and Nicotine Dependence in Alcohol-Dependent Men and Women

Daeppen, Jean‐Bernard; Smith, Tom L.; Danko, George P.; Gordon, Lauren; Landi, Nancy A.; Nürnberger, John I.; Bucholz, Kathleen K.; Raimo, Eric B.; Schuckit, Marc A.

doi:10.1093/alcalc/35.2.171

Cited by 134 publications

(87 citation statements)

References 30 publications

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“…Although some studies have found no differences in the ability to quit smoking on the basis of alcohol problems (e.g., Hayford et al, 1999;Sobell et al, 1995), the majority of studies demonstrate that individuals with current or past history of alcohol problems are more nicotine dependent and are less likely to be successful at quitting smoking, compared to those without alcohol problems (e.g., Daeppen et al, 2000;Di Franza & Guerrera, 1990). One possible reason for this population's reduced ability to quit smoking is that alcohol use promotes smoking relapse (Baer & Lichenstein, 1988;Shiffman 1986;Shiffman et al, 1996;Zimmerman et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

Modeling the effect of alcohol on smoking lapse behavior

et al. 2006

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The primary aim of this project was to examine the role of alcohol use in smoking lapse behavior, as alcohol consumption is a known risk factor for poor smoking cessation outcomes. We have developed a novel human laboratory model to examine two primary aspects of alcohol-mediated tobacco relapse: 1) Does alcohol facilitate the initiation of the first cigarette? 2) Once the first cigarette is initiated, does alcohol facilitate subsequent smoking? Using a within-subject design, 16 daily smokers who were also heavy social drinkers received a priming drink (0.03 g/dl or taste masked placebo) and then had the option of initiating a tobacco self-administration session or delaying initiation by five minute increments for up to 50 minutes in exchange for monetary reinforcement. Subsequently, the tobacco self-administration session consisted of a one-hour period, in which subjects could choose to smoke their preferred brand of cigarettes using a smoking topography system or receive monetary reinforcement for cigarettes not smoked. Alcohol craving, tobacco craving, subjective reactivity to alcohol, and nicotine withdrawal were assessed as secondary outcomes. Results demonstrated that after consuming the alcohol beverage, subjects were less able to resist the first cigarette and initiated their smoking sessions sooner, and smoked more cigarettes compared to the placebo beverage. These findings have implications for smoking cessation in alcohol drinkers and model development to assess smoking lapse behavior. Keywordssmoking; lapse behavior; alcohol; craving; human laboratory; monetary reinforcement It is well established that alcohol consumption and tobacco use are highly correlated in both clinical and non-clinical samples. Among alcoholics, 80% to 95% are smokers (DiFranza & Guerrera, 1990;Hughes, 1993;Kalman et al., 2005;Patten et al., 1996;Sobell et al., 1990), as compared to 23% in the general population (CDC, 2003 (DiFranza & Guerrera, 1990;Grant et al., 2004;Hurt et al., 1994) and the severity of alcohol and tobacco dependence is positively correlated (Ellingstad et al., 1999;Gulliver et al., 1995). Smoking is also highly correlated with drinking in nonalcoholic individuals (Carmody et al., 1985;Istvan & Matarazza, 1984), particularly among those who are heavy drinkers. Both laboratory studies and naturalistic observations have demonstrated that alcohol consumption is strongly associated with increased rates of smoking (Glautier et al., 1996;Mitchell et al., 1995;Shiffman et al., 1994). Additionally, there is evidence for cross-substance craving from both clinical and non-clinical samples (Drobes et al., 2000;Tiffany, 1995). Given the high co-occurrence of alcohol and tobacco use, it is not surprising that alcohol has been identified as a risk factor for poor smoking cessation outcomes (Baer & Lichenstein, 1988;Shiffman 1986;Zimmerman et al., 1990). For example, Shiffman (1986) found that 20% of all relapse episodes in smokers involved alcohol consumption. In a real-time examination of first lapse episodes, ...

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Section: Discussionmentioning

confidence: 99%

Modeling the effect of alcohol on smoking lapse behavior

et al. 2006

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“…Although some studies have found no differences in the ability to quit smoking on the basis of alcohol problems (e.g., Hayford et al 1999;Hughes et al 2003;Hurt et al 1995;Sobell et al 1995), many studies demonstrate that individuals with current or past histories of alcohol problems are less likely to be successful at quitting smoking compared to those without alcohol problems (e.g., Daeppen et al 2000;Di Franza and Guerrera 1990;Hughes 1995). However, little is known about how to best promote smoking cessation in this population of drinkers who are at increased risk for alcohol-mediated tobacco relapse (Baer and Lichenstein 1988;Brandon et al 1990;Sobell et al 1990;Shiffman et al 1994Shiffman et al , 1996Zimmerman et al 1990).…”

Section: Discussionmentioning

confidence: 99%

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

et al. 2007

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Rationale-Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior.Objective-The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior.Materials and methods-Subjects (n=19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/ dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed.Results-We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch.Conclusions-In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.

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“…De hecho, entre el 80 y el 95% de alcohólicos fuman, lo que supone un porcentaje tres editorial veces mayor que en la población general 3 . A la vez, los fumadores tienen un grado de dependencia del alcohol mayor 4 . Se estima que el alcoholismo es 10 veces más común en fumadores que en no fumadores 5 .…”

Section: Introductionunclassified

El tratamiento del tabaquismo en alcohólicos: ¿miopía o negligencia?

Nieva

Gual

2005

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RESUMENLas drogodependencias más prevalentes en nuestra sociedad son el tabaquismo y el alcoholismo. En el caso de la población alcohólica, el consumo de tabaco está presente en un alto porcentaje de casos. Las repercusiones del consumo de ambas sustancias a la vez son devastadoras. Estudios que analizan la causa de muerte han identificado el tabaquismo como principal factor responsable de muerte en alcohólicos abstinentes. Sorprendentemente, poca ha sido la atención que ha merecido la dependencia tabáquica de estos pacientes por parte de los profesionales de los centros de drogodependencias de nuestro país.Este artículo pretende evidenciar la importancia que juegan los profesionales para cambiar esta realidad y mejorar la calidad de vida de esta población. Tradicionalmente, la intervención en tabaquismo se aplaza tras varios años de abstinencia alcohólica, sin embargo los últimos hallazgos apuntan que tres meses después de la última ingesta, es tiempo suficiente para que el tratamiento del hábito tabáquico no aumente el riesgo de recaída alcohólica. Así mismo, hay tratamientos efectivos para facilitar el proceso de dejar de fumar en estos pacientes. ABSTRACTSmoking and alcohol drinking are the most common addictions in our society. In an alcohol-dependant population, tobacco use is present in a high percentage of cases. The health consequences of concurrent consumption are devastating. Research into mortality rates has identified tobacco use as the leading cause of death among abstinent alcoholics. Surprisingly, the tobacco dependence of these patients has not received the attention it merits from health professionals working in drug abuse centres in our country.This article endeavours to show the importance of the role of health professionals in changing this situation and in improving the quality of life of these patients. Traditionally, treating tobacco use was delayed until after several years of alcohol abstinence. However, the latest evidence shows that a lapse of three months after the last drink is enough to commence smoking cessation intervention without jeopardizing alcohol abstinence. Moreover, there are effective treatments in facilitating smoking cessation in these patients.

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Clinical Correlates of Cigarette Smoking and Nicotine Dependence in Alcohol-Dependent Men and Women

Cited by 134 publications

References 30 publications

Modeling the effect of alcohol on smoking lapse behavior

Modeling the effect of alcohol on smoking lapse behavior

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

El tratamiento del tabaquismo en alcohólicos: ¿miopía o negligencia?

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