Co-Use of Tobacco and Alcohol Is Associated With Blunted Blood Pressure Responses During Stress: A Prospective...

Tobacco smoking has been described as a gateway to substances, such as alcohol during adolescence, and both are often used in times of stress. While the effects of smoking on cardiovascular stress responses are well documented, alcohol use is generally restricted for an arbitrary time period or covaried. Additionally, how tobacco and alcohol co-users respond to acute psychological stress has yet to be determined. The present study sought to examine prospective associations between baseline substance use and cardiovascular reactivity 9-14 years later. Specifically, we examined the impact of tobacco-only use, alcohol-only use, co-use, and non-use on cardiac activity in response to acute stress. Data were drawn from a sample of 774 participants from the Midlife Development in the United States (MIDUS) series. Participants had their blood pressure and heart rate monitored during a standardized laboratory protocol where they completed self-report questionnaires and mental arithmetic and Stroop tasks. Results showed that co-users had lower diastolic blood pressure responses during stress compared to alcohol-only users. Co-users also reported lower positive affect and higher negative affect. They reported an earlier age of onset for both tobacco and alcohol, a greater number of cigarettes smoked, and more alcohol-related problems. The findings extend earlier observations of blunted stress responses in substance users and indicate the need to examine their implication in predicting relapse.