Recovering alcoholics find nicotine more
"rewarding" than people who have no history of drinking problems, and
probably need special help in trying to quit, according to new
research.
Although between 80 and 95 percent of alcoholics smoke
cigarettes, a rate that is three times higher than the general population,
and 70 percent of alcoholics are heavy smokers compared with just 10
percent of the population, very few studies have been done about the
association between the two.
However, a new study in the November
issue of Alcoholism:
Clinical & Experimental Research closely examined this
association to see if smokers with a past history of alcoholism are more
nicotine dependent than smokers with no problem drinking
history.
Predisposed?
"There are many theories of why smoking and alcoholism go
together," said John R. Hughes, professor of psychiatry at the University
of Vermont and lead author of the study in a news release. "Some studies
suggest that the same genes that predispose people to alcoholism also
predispose them to smoking. Some have thought there is an 'addictive
personality' that becomes addicted to many things, but research suggests
this is not so."
"Another idea is that since smoking stimulates and
alcohol relaxes, smokers use alcohol to prevent over-stimulation from
smoking and alcoholics use cigarettes to prevent sedation," he said. "Yet
another idea is that those who become alcoholics are people who use
substances for the drugs within them, for example, to get high or to cope
with life. This theory would predict that alcoholic smokers use tobacco
mostly for the nicotine in it."
Using nicotine gum, Hughes' study
examined if smokers with a past history of alcoholism would
self-administer nicotine more often and in greater amounts than
non-alcoholic smokers. They found that smokers with a history of
alcoholism said they didn't enjoy nicotine more, but they did more often
choose to use pure nicotine, and ingested greater levels of nicotine than
smokers without this history.
"It may seem unusual," explained
Hughes, "that we found a difference between the self-administration or
rewarding effects of nicotine and the subjective effects or the liking of
nicotine. Usually these two go hand in hand, but not always. In fact, many
smokers state they can't understand their use of cigarettes because they
feel they really don't get much out of it. Sometimes we can like something
but not be able to express what it is we like about it."
Smoking More Dangerous
"Many in the alcohol field did not feel smoking was an
important problem for alcoholics, that maintaining sobriety was the
critical factor," said Kenneth A. Perkins, professor of psychiatry at the
University of Pittsburgh Medical Center. "Most studies in the smoking
field would exclude those with current or past alcohol dependence.
Furthermore, funding has typically come from different agencies - one for
alcohol, another for smoking/nicotine - which allowed studies of alcohol
and smoking to fall through the cracks."
But Hughes said recent
data shows that smoking kills more alcoholics than alcohol does. According
to the American Cancer Society, smoking is the most preventable cause of
death in American society. Nearly one in five deaths in the U.S. results
from the use of tobacco; more than 400,000 die from smoking in the U.S.
each year.
"What this means," said Hughes, "is that we need to get
alcoholics to stop smoking either while stopping their alcohol or soon
after. Our study suggests these smokers especially need to use medications
that fight nicotine dependence, like the patch, gum, an inhaler, or
Zyban."
