Alcohol and tobacco co-use in nondaily smokers: an inevitable phenomenon?

Alcohol use has consistently been associated with smoking among nondaily smokers. However, this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long-term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non-smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol-tobacco co-administration patterns.

183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face-to-face interviews during which they provided details about their lifetime and past-week tobacco and alcohol administration patterns.

EOS were more likely to report having used alcohol at the time of their first-ever cigarette relative to the other subgroups (P ≤ 0.001), but there were no differences in past-week co-administration patterns between the subgroups. Overall, less than one-third of all smoking sessions occurred when drinking, but these accounted for more than half of all cigarettes consumed during the previous week. Moreover, while only 42% of drinking sessions involved tobacco co-administration, when drinking and smoking did co-occur, significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01).

Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co-administration is associated with mutual dose escalation.