Smoking and alcohol

[Don S]

Smoking and alcohol
Excerpted from
www.unhooked.com/nosmoke/

Did you know that more alcoholics die of diseases related to smoking than of diseases related to drinking?

Nicotine increases the craving for alcohol. For many alcoholics, smoking is also a behavioral trigger for drinking…. Studies have shown also that alcoholics can quit drinking and smoking at the same time, and modern treatment centers are increasingly based on this principle.

Before the 1930s, treatment of alcoholism and drug addiction commonly also included treatment of nicotine addiction. Smoking was generally viewed as a contributing factor in alcohol and drug relapses. But with the rise of Alcoholics Anonymous (AA), concern with smoking as a recovery issue faded into the background.

* More than 90 per cent of alcoholics smoke, compared to fewer than a third of non-alcoholics.
* Alcoholics smoke more cigarettes per day than do nonalcoholic smokers.
* Alcoholics are more likely to smoke mentholated cigarettes.
* The number of cigarettes a person consumes rises in tandem with the number of drinks consumed.
* Almost every smoker who smokes more than two packs a day is also an alcoholic.

Smokers drink twice as much alcohol as non-smokers--and their risk of drinking too heavily is also twice that of non-smokers. One study found that alcoholism is 10 to 14 times more prevalent among smokers. And, while the percentage of smokers has dropped to 30 percent of American adults, it is unchanged among alcoholics [as of 1997].

New research indicates that nicotine causes the brain to crave alcohol… nicotine use increases alcohol consumption…. trying to quit both habits at once, painful as it may be in the short-term, may well be a better long-term strategy.



[Killed by smoking:]
• The co-founders of Alcoholics Anonymous. "Bill W. was lifted to the podium in his wheelchair, oxygen tank at his side. He was dying of lung disease.

• The other co-founder of AA, Dr. Bob, was a cigar smoker. He died of throat cancer.

• Caroline Knapp, who chronicled her struggles with alcoholism in the memoir "Drinking: A Love Story," died …after a battle with lung cancer. She was 42.

As if to drive home the point, RJR, the maker of Winston, has brought out a new brand of cigarettes, EVO, that comes in a package shaped like a hip flask.

One lungful of smoke immediately floods the brain with dopamine, a powerful neurotransmitter.

When rats were given nicotine for a week and then it was withdrawn, their brains registered a 40 per cent drop in response to pleasure stimuli for periods lasting from several days to as long as two weeks. These brain changes "rival the magnitude and duration of similar changes observed during withdrawal from other abused drugs such as cocaine, opiates, amphetamines, and alcohol…."

"There is no research support for the contention that alcoholics should not try to quit smoking at the same time they are attempting to quit drinking. In fact, the research more closely supports the view that 'smoking and drinking are correlated behaviors; anything causing a reduction in one may be associated with a reduction in the other.'"

Source: T. Bien and R. Barge, Smoking and Drinking, a Review of the Literature (1990), International Journal of the Addictions 25(12).

Alcoholics seem to develop a deeper dependence on nicotine and may have more difficulty quitting smoking than do non-alcoholics.

Treating multiple addictions at once does not seem to make recovery any more difficult.
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“Unlike the alcoholism field, which is still dominated by the quasi-monopoly of AA with its religious 12 Steps, the field of smoking cessation presents a wide-open smorgasbord of different approaches, practically all of them secular.

There are two broad branches, the pharmacological and the behaviorist. The "patch," the gum, the nasal spray and the nicotine inhaler are methods of delivering nicotine to your system without smoking, on the theory that you will gradually wean off.

Use of such nicotine replacements is vastly more effective if done in combination with some kind of behavioral therapy. There are numerous behavioral approaches, often used together. Common ones include tapering or fading, scheduling or timing, motivational enhancements via rewards and punishments of different kinds, relapse prevention, cue exposure, aversion therapy, and others.

New medications for both nicotine addiction and alcoholism are on the way, now that scientists realize that addictions stem from much more than "an addictive personality" or weak will. The remedies being tested actually target the cascade of neurochemical events at the root of addicts' cravings.

Isradipine, a drug recently shown to reduce the desire for alcohol, is a calcium-channel blocker normally used to treat high blood pressure. The compound also appears to affect levels of dopamine in the brain's reward center. Similarly, a prescription antidepressant called bupropion, marketed commercially as Wellbutrin for depression and Zyban as a smoking cessation aid, seems to block smokers’ cravings by mimicking nicotine's ability to increase the amount of dopamine in the brain.

Recent experiments with a new medication, Rimonabant, suggest that this drug not only helps people quit smoking but also helps them lose weight at the same time. Link.

There are numerous other approaches as well: nutrition, hypnosis, acupuncture, herbal teas, you name it. There's undoubtedly a quantity of worthless and even harmful hype as well, so be alert. Some methods are done alone, some in groups. There are commercial programs, non-commercial programs, inpatient and outpatient programs, and there is a growing self-help literature.

There are not yet, apparently, any programs aimed specifically at the sober alcoholic or drug addict who wants to quit smoking. But then, as a person who has successfully quit drinking and/or drugging, you already know a lot about addiction and you have a head start!”