Brain and Body

Throw Out Your Cigarettes if You Want to Stay Sober

October 6, 2015 | Kelly Tatera

Woman smoking and drinking an alcoholic beverage
Photo credit: Aleksandr Zykov/Flickr (CC BY-SA 2.0)

New research finds that recovering alcoholics who smoke are twice as likely to relapse than nonsmokers.

Alcohol and cigarettes seem to go hand in hand — many drinkers report that the buzz from a couple drinks sparks the craving to light up. In fact, some people only enjoy cigarettes when they’re consuming alcohol but can’t stand them when they’re sober. Smoking is a dangerous habit for everyone, but ex-alcoholics who smoke are at an especially high risk; their chance of relapsing doubles.

Lead author Renee Goodwin, an associate professor in the Department of Epidemiology at the Mailman School of Public Health, speculates that rehab facilities think it would be “too difficult” for a patient to quit smoking and drinking at the same time, and that the nicotine dependence won’t make a difference in the long run. However, the new research finds fault in this way of thinking.

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“Quitting smoking will improve anyone's health," Goodwin said in a press release, "But our study shows that giving up cigarettes is even more important for adults in recovery from alcohol since it will help them stay sober."

Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the researchers looked at the habits of nearly 35,000 adults with past alcoholism. They were assessed two times during a three year period to examine substance use as well as physical and mental disorders. Daily smokers had about twice the odds of an alcohol relapse compared to nonsmokers, and the results held up even after controlling for certain factors like mood, anxiety, illicit drug use, and nicotine dependence.

While the study didn’t pinpoint an exact reason for why smoking cigarettes encourages alcohol relapse, the researchers presume that the behavioral and neurochemical links between smoking and alcohol contribute to the problem. Cigarettes don’t get you inebriated by any means, but daily smoking continues a habitual act similar to the alcohol addiction. Plus, since the two activities often go hand-in-hand, smoking might intensify the craving for a drink, since the same happens vice versa.

While the researchers hope these findings will encourage rehabilitation facilities to crack down on smoking, Goodwin says the way forward is not entirely clear. She told Yale Daily News that researchers will still have to determine the best approach for administering the dual treatment that the study suggests is essential for recovery.

According to the National Institute on Alcohol Abuse and Alcoholism, between 80 to 95 percent of alcoholics also smoke. Now that this study has found a correlation between continued smoking and relapse, hopefully healthcare providers will restructure rehab programs to build a better foundation for long term sobriety.

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