Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment

This study examined alcohol use and its association with initial smoking lapses among heavy nondependent drinkers in smoking cessation treatment.

Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment.

Of the 178 participants who reported a smoking lapse, 41.5% lapsed when drinking alcohol. Those who had alcohol-involved lapses had significantly lower tobacco dependence severity and drank more drinks per week than those who had non-alcohol-involved lapses. The majority of alcohol-involved lapses were in a bar/restaurant, with other people, and when they were in a happy/good mood. In survival analyses with alcohol consumption as a time-varying covariate, moderate drinking days were associated with almost four times greater risk of smoking lapse than non-drinking days, and heavy drinking doubled the risk of lapsing compared with moderate drinking.

Results suggest that alcohol-related lapses are qualitatively different from lapses that do not involve alcohol. Furthermore, among heavy drinkers in cessation treatment, even moderate alcohol use is associated with increased risk of smoking, with heavy drinking further increasing the risk. Smoking cessation treatments for heavy alcohol drinkers should highlight the lapse risk associated with any alcohol consumption and with heavy drinking during a quit smoking attempt.