A recently published Yale-affiliated study may change the way doctors treat alcohol-use disorders in patients who smoke cigarettes.
Smokers recovering from alcohol dependence often continue smoking in an effort to alleviate the discomfort of withdrawal, according to the study. But the researchers determined that this cigarette use has an adverse impact on patients’ likelihood of staying sober in the long-run. Patients in treatment for alcohol-use disorders who smoke cigarettes are far less likely to relapse if they are concurrently treated for cigarette smoking habits, the study indicated.
“What we found is that adults with a past alcohol-use disorder who were smokers were more likely to meet criteria for alcohol-use disorders three years later, compared to adults with a past alcohol-use disorder who were not smoking,” first author and Yale School of
Medicine psychiatry professor Andrea Weinberger said.
Past research on the subject has generally focused on how alcohol use affects patients trying to overcome nicotine addiction, but this study considered the opposite. Using data from two iterations of the National Epidemiologic Survey on Alcohol and Related Conditions, researchers used logistic regression analysis to evaluate the relationship between the respondents’ initial cigarette-smoking status and their alcohol use three years later.
Researchers also adjusted for a number of variables that could have distorted their calculations, including demographics, psychiatric disorders and substance-abuse disorders.
Even after accounting for these factors, the data exhibited a clear correlation between cigarette use in the initial survey and higher likelihood of alcohol dependence in the subsequent survey.
“I think it’s compelling and very applicable to treatment,” senior author and Columbia University epidemiology professor Renee Goodwin said.
Smoking was permissible within the confines of hospital rooms as late as the 1990s, Goodwin said. But while the medical profession’s understanding of smoking as a health hazard has seen enormous progress since the days when patients smoked in their hospital beds, Weinberger said more remains to be done.
“We hope that this will raise awareness of the relationship between smoking and alcohol-use disorders and encourage programs to assess for smoking and consider including services to help people stop smoking,” Weinberger said.
But the way forward is not entirely clear, Goodwin said. Researchers have yet to determine the best way to administer the type of dual treatment this study suggests is necessary, she added.
Director of the National Institute on Alcohol Abuse and Alcoholism George Koob said a staggered treatment plan seems the most likely solution.
“It is great to treat both, but it may have to be done sequentially,” Koob said.
But Goodwin hesitated to offer any concrete recommendation without more extensive research on the subject.
“My main message is that we need to try to test these things, then see what [the] evidence suggests,” she said.
According to the NIAAA, between 80 and 95 percent of alcoholics also smoke cigarettes.