Nicotine Increases Alcohol Craving
11/08/03
People who smoke and try to quit drinking have a more difficult time not relapsing, because new scientific evidence indicates that nicotine may actually cause a craving for alcohol.
If you combine this factor with another new study which indicates that nicotine addiction may be as powerful as an addiction to heroin, smokers who want to stop drinking face an extremely difficult battle indeed.
Although many treatment programs and self-help support groups recommend addressing "one addiction at a time," treatment approaches that insist that clients give up all addictive substances simultaneously may be more effective, according to these new studies.
Alcohol-Nicotine Relationship
Led by Toronto's Dr. Dzung Anh Le, a study on rats by Canadian and U.S. scientists has found that nicotine use increases alcohol consumption, and the two addictions may work hand in hand.
The research relevant to humans who drink both excessively and moderately, said Dr. Le. It suggests that to quit drinking, a person might also have to give up smoking as well. "It has a lot of implications for treatment strategy," said Dr. Le, of the Centre for Addiction and Mental Health. "What we knew before is alcohol and tobacco are extensively co-abused. We wanted to find a biological basis for this co-dependency."
Dr. Ted Boadway of the Ontario Medical Association said although treating dual addictions is already a cornerstone of many therapies, anti-smoking strategies do not always emphasize curbing alcohol intake. Guidelines on stop-smoking approaches usually do not consider the effect alcohol may have on smokers. The study appears in the U.S. journal Alcoholism: Clinical and Experimental Research.
The Research
It is nicotine, the addictive ingredient in cigarettes, which leads to an increase in alcohol consumption, said Dr. Le and fellow researchers at the Indiana University School of Medicine. "Of the study's five experiments on rats, three confirmed researchers' suspicions that nicotine and alcohol "can act through the same rewarding system in the brain," said Dr. Le.
Both nicotine and alcohol lead to the release of dopamine, the "feel-good brain chemical," although the mechanism by which this occurs is not completely understood, Dr. Le said. "Repeated exposure to nicotine through smoking can enhance the pleasurable effects of alcohol, and there's probably some biological basis for this," although it's not completely understood.
The remaining two experiments in Dr. Le's study examined nicotinic receptor antagonists in the brain, and whether they could be altered to block the effects of nicotine and alcohol.
Highly Addictive
Meanwhile, the Royal College of Physicians in Britain released a report calling nicotine "a powerful addictive substance on a par with heroin and cocaine" which should be controlled like a drug or medicine.
The report said cigarettes are nicotine delivery products and said nicotine addiction should be recognized as a major medical and social problem. "It is time for nicotine to become a major health priority," Sir George Alberti, the president of the college, said.
The tobacco industry disputed the report's findings.
These new reports provide scientific evidence that those who try to quit drinking, but continue to smoke, face a more difficult problem than those who do not smoke, or who quit smoking and drinking simultaneously.
Other Cravings
Also this week, National Institute on Drug Abuse researchers released two studies that found that craving for nicotine appears to be linked to increased craving for illicit drugs among drug abusers who also smoke tobacco.
The two studies, said NIDA Director Dr. Alan I. Leshner, "add very strong behavioral evidence to other research that suggests common characteristics and interactions between tobacco use and opiate and cocaine use. They also suggest that smoking cessation programs should be offered as part of other drug treatment programs."
In one of the studies, researchers found that the amount of cocaine and heroin use was directly related to the level of tobacco use. "The more cigarettes smoked, the more likely the person was to use illegal drugs," said Dominick Frosch, a doctoral student at San Diego State University.