Alcohol consumption may be in response to smoking cessation

More than 1,200 people die in the United States every day from smoking-related illnesses. This is equivalent to three airplanes loaded with passengers crashing everyday in America. Smoking-related illnesses are the No. 1 cause of preventable deaths in the country, killing more Americans than drugs, homicides, suicides, accidents, and fires combined.

Previous studies have indicated that alcohol use can increase smoking and smoking urges. However, no studies have examined the moment-to-moment relation between smoking urges and alcohol use during a smoking cessation attempt.

Michael Businelle, Ph.D., assistant professor at The University of Texas School of Public Health, part of UTHealth, and colleagues collected data from 302 female participants between the ages of 18 and 70 who were attempting smoking cessation in Seattle between 1999 and 2002. Businelle and colleagues exclusively focused their study on smoking cessation in women because women have greater difficulty with quitting as compared to men.

Participants recorded their individual smoking urges at random time points throughout the day as cued by hand held computers. Participants also completed temptation assessments each time they felt an urge to smoke.

Overall, subjects reported higher and more volatile smoking urges on days when alcohol was consumed. "Interestingly, these higher, more volatile smoking urges were reported before the individual actually began drinking, suggesting that alcohol consumption may have been in response to smoking urges rather than vice versa" Businelle said. While smoking urge volatility increased following alcohol consumption, the smoking urge trajectory did not.

Additionally, the study showed that women were more likely to drink alcohol on days when they woke up with higher urges to smoke as compared to days when they woke up to lower smoking urges. This finding may indicate that women undergoing a cessation attempt may try to reduce cessation-related stress by using alcohol. This pattern of urges and alcohol consumption could indicate a vicious cycle whereby smoking urges could lead to alcohol consumption, and, in turn, lead to greater urges to smoke and increased likelihood of relapse.

"Identification of situations that increase the risk for relapse will aid in the development of novel interventions that can address these situations in the moment of occurrence," said Businelle.

According to Businelle, "On any given quit attempt, five out of 100 people are successful at quitting 'cold turkey,' 32 percent of those who take varenicline successfully quit, 25 percent of those who use patches and/or gum successfully quit, while those who combine counseling with medications have the best quit rates, greater than 30 percent."

Businelle recommends seeing a physician to assist in smoking cessation, along with the following tips:

• Tracking cigarette smoking and urges by time of day and intensity.
• Get rid of all lighters, cigarettes and ashtrays.
• Participate in exercise or other healthy activities that are not compatible with smoking.
• Tell family and friends of your plan to quit smoking, which can build social support for a quit attempt while adding social pressure to quit.

Research was funded with grants from the National Cancer Institute (R01CA74517), part of the National Institutes of Health, and the American Cancer Society.