Low-to-moderate alcohol consumption and smoking cessation rates: retrospective analysis of 4576 elderly ever-smokers

Smoking and alcohol consumption are two major risk factors for manifold morbidity and mortality outcomes and are highly correlated with each other. No conclusion has been reached concerning whether cigarette smokers drinking alcohol have more difficulties with smoking cessation. We aimed to elucidate the association of concurrent alcohol consumption with the probability of smoking cessation in non-clinical populations.

Retrospective analysis in 4576 ever-smoking participants of the baseline survey of ESTHER, a population-based study in Germany, aged 50-74 at enrollment in general practitioner offices. Life-course histories of alcohol consumption were obtained from questionnaire items covering exposure intensities at ages 20, 30, 40, 50 and at the time of enrollment. Extended Cox regression modelling allowing for the time-varying nature of alcohol consumption was employed to model the time from smoking initiation to smoking cessation.

Using alcohol abstainers as the reference group and controlling for potential confounders, relative cessation rates (95% CI) increased to 1.17 (1.02, 1.34), 1.36 (1.20, 1.55), 1.45 (1.27, 1.66) and 1.32 (1.13, 1.53) with concurrent consumption of 1-39, 40-99, 100-199 and 200+g alcohol/week. This pattern persisted in extensive sensitivity analyses.

The results of these analyses of time-varying concurrent alcohol consumption and smoking suggest that drinking low-to-moderate amounts of alcohol as common in the general population might actually facilitate cessation in non-clinical settings.