SAN DIEGO – During short-term abstinence from nicotine, alcohol-dependent cigarette smokers experience greater negative affect-related craving to smoke and more persistent negative affect, compared with cigarette smokers who are not alcohol dependent.
“Our [preliminary] findings suggest the experience of nicotine withdrawal and associated urge to smoke may be different for smokers with alcohol dependence even when severity of nicotine dependence is taken into account,” researchers led by Jaimee L. Heffner, Ph.D., noted at a poster session at the annual scientific conference of the Research Society on Alcoholism.“Negative reinforcement motives for smoking may be a critical factor [in designing] intervention strategies for smokers with alcohol dependence.”
In what they believe to be the first study of its kind, the researchers, from the Cincinnati VA Medical Center and Tri-State Tobacco and Alcohol Research Center at the University of Cincinnati, enrolled 39 alcohol-dependent smokers and 19 control smokers who were in a substance abuse treatment program. They were abstinent from alcohol and other non–nicotine drugs for at least 60 days before testing. Those with Axis I disorders were excluded.
During a 6-hour session, each participant underwent the Semi-Structured Assessment for the Genetics of Alcoholism, the Fagerstrm Test for Nicotine Dependence, the Questionnaire on Smoking Urges–Brief (QSU), and the Profile of Mood States (POMS). To assess smoking urges, the QSU was done at baseline, 150 minutes, and 300 minutes; the POMS was done at baseline, 60 minutes, 180 minutes, and 300 minutes to assess negative affect.
Alcohol-dependent smokers were similar to the control smokers in age (a mean of 40 years vs. 39 years, respectively), gender (56% vs. 53% male), and race (69% vs. 79% white), and in terms of their severity of nicotine dependence (92% vs. 84%) and mean number of cigarettes smoked per day (21 vs. 18). Alcohol-dependent smokers had significantly higher rates of cannabis use (59% vs. 21%) and other drug use disorders (62% vs. 11%).
After controlling for nicotine dependence, alcohol-dependent smokers reported significantly greater craving for negative affect relief, compared with control smokers (P = .022), but no group by time interaction was seen.
“The main effect of time was contrary to what had been expected,” they wrote. “POMS scores tended to decrease over the course of the testing session. A significant group by time interaction was detected, indicating that negative affect declined more precipitously for control than for alcohol-dependent smokers [P = .005].”
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Major Finding: Negative affect declined more precipitously for control than for alcohol-dependent smokers (P = .005).
Data Source: Substance-abuse program participants without Axis I disorders: 39 alcohol-dependent but alcohol-abstinent smokers and 19 control smokers.
Disclosures: The National Institute on Alcohol Abuse and Alcoholism and the Department of Veterans Affairs Research Service supported the study with grants.