For some of us, drinking may seem to naturally go hand-in-hand with smoking: It's a time-honored combination, although it's not one that's particularly healthful.
But the lure of lighting up a cigarette while cracking open a cold one may go deeper than just a moment's pleasure, according to an Oregon State University researcher who is the lead author of a just-published study. And the study suggests that reducing drinking could help people quit smoking.
Sarah Dermody, the study's lead author, is an associate professor in OSU's School of Psychological Science. She studies risky behaviors such as alcohol and nicotine use (and, yes, it turns out that these substances can be risky) and also has studied how the two interact with each other.
One of her goals, she said, is to help find better ways for people to quit smoking: Even after decades of education about the health hazards of tobacco, about 17 percent of Americans still smoke — a figure that has remained relatively steady for years.
"Smoking cessation is really challenging for people," she said — in part because nicotine is stunningly addictive; so addictive, in fact, that studies show that nearly two-thirds of people who even try smoking become, at some point, daily smokers.
Dermody's new study, done with colleagues at the Centre for Addiction and Mental Health in Toronto, probes the linkage between cigarettes and alcohol. In addiction studies, the link is well-established (and not particularly surprising): Drinking is a risk factor for smoking, and the reverse is true as well. Part of the reason why that's true, Dermody said, may be that alcohol and smoking interact with some of the same receptors in the brain.
Dermody and her colleagues examined 22 daily smokers who were seeking treatment for severe problem drinking. They studied what's known as the nicotine metabolite rate in each of those subjects.
The nicotine metabolite rate is a measurement of how quickly the body metabolizes nicotine; generally speaking, the higher the rate, the more quickly the body breaks down nicotine.
For reasons that aren't completely understood yet, people with higher rates are likely to smoke more and have a harder time quitting. (They're also less likely to successfully quit using nicotine replacement therapy products.) One theory why that's the case, Dermody said, is that smokers with higher rates crave more nicotine as their bodies break down the drug, but no one knows for sure.
But here's the interesting finding for people whose new year's resolutions include quitting smoking: As the men in the study reduced their drinking (from an average of 29 drinks a week to seven), their nicotine metabolite rate also dropped.
The women in the study did not see reductions in their rate, but Dermody said that's because those subjects did not significantly reduce their drinking during the study period.
"In some ways," she said, that result among women in the study confirms the researchers' hypothesis" — but she added that she plans to launch a larger study to include more women as well as additional men. That followup work will continue to test the hypothesis that a drop in the nicotine metabolite rate could make it easier for people to stop smoking.
In the past, Dermody said, researchers thought people's nicotine metabolite rate was relatively stable, but the new study (published in the journal Nicotine & Tobacco Research) challenges that belief. And the findings have a clinical implication as well: Doctors who are helping their patients try to stop smoking might do well to persuade them to cut back on their alcohol consumption as well.
It's all part of a broader picture of addiction that slowly is coming into view. Dermody said evidence suggests that "chronic exposure of the brain to drugs like nicotine can change the way that the brain is wired." For heavy smokers, she said, "all of their systems have been impacted by this history of smoking."
Dermody considers vaping, recently labeled a public health crisis among youth by the U.S. surgeon general, a "mixed bag" — in some cases, it can be useful in helping people quit smoking. But she pointed to evidence suggesting that at least some vapers don't quit smoking and have instead added ecigarettes to their arsenal of nicotine-delivery tools.
There's real value in helping people quit smoking: According to the federal Centers for Disease Control and Prevention, smoking-related illness in the United States costs more than $300 billion each year, including nearly $170 billion for direct medical care for adults and more than $156 billion in lost productivity.
Giving medical professionals additional tools to address both smoking and alcohol abuse may be one effective way to cut into that bill. (mm)