Nicotine interactions with low-dose alcohol: pharmacological influences on smoking and drinking motivation.

An extensive literature documents a close association between cigarette and alcohol use. The joint pharmacological effects of alcohol and nicotine on smoking and drinking motivation may help explain this relationship. This experiment was designed to test the separate and combined pharmacological effects of nicotine and a low dose of alcohol (equivalent to 1-2 standard drinks) on substance use motivation using a double-blind and fully crossed within-subjects design. Participants (N = 87) with a wide range of smoking and drinking patterns completed 4 counterbalanced experimental sessions during which they consumed an alcohol (male: 0.3g/kg; female: 0.27g/kg) or placebo beverage and smoked a nicotine (.6 mg) or placebo cigarette. Outcome measures assessed the impact of drug administration (alcohol or nicotine) on craving to smoke, craving to drink, affect, and liking of the beverage and cigarette. Results indicated that combined administration produced higher cravings to smoke for the entire sample, as well as higher cravings to drink among women and lighter drinkers. Heavier users of either alcohol or cigarettes also exhibited enhanced sensitivity to the effects of either drug in isolation. Separate, but not interactive, effects of alcohol and nicotine on mood were observed as well as both same-drug and cross-drug effects on beverage and cigarette liking. Together, these findings support the notion that the interactive pharmacological effects of nicotine and low doses of alcohol play an important role in motivating contemporaneous use and suggest roles for cross-reinforcement and cross-tolerance in the development and maintenance of alcohol and nicotine use and dependence.

[1]  S. Glautier,et al.  Alcohol and the reward value of cigarette smoking , 1996, Behavioural pharmacology.

[2]  P. Albert,et al.  Models for longitudinal data: a generalized estimating equation approach. , 1988, Biometrics.

[3]  A. Lajtha,et al.  Nicotine: Alcohol Reward Interactions , 2010, Neurochemical Research.

[4]  O. Pomerleau.  Individual differences in sensitivity to nicotine: Implications for genetic research on nicotine dependence , 1995, Behavior genetics.

[5]  S. Hall,et al.  A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. , 2004, Journal of consulting and clinical psychology.

[6]  Suchitra Krishnan-Sarin,et al.  Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration , 2008, Psychopharmacology.

[7]  Hsiao-ye Yi,et al.  An Epidemiologic Analysis of Co-Occurring Alcohol and Drug Use and Disorders , 2008, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[8]  Linda C. Sobell,et al.  Alcohol Timeline Followback , 2000 .

[9]  K. Perkins,et al.  Subjective and cardiovascular responses to nicotine combined with alcohol in male and female smokers , 1995, Psychopharmacology.

[10]  A. King,et al.  Alcohol dose-dependent increases in smoking urge in light smokers. , 2005, Alcoholism, clinical and experimental research.

[11]  H. de Wit,et al.  Effects of varying ethanol dose on cigarette consumption in healthy normal volunteers , 1995, Behavioural pharmacology.

[12]  S. Shiffman,et al.  Smoking patterns and dependence: contrasting chippers and heavy smokers. , 2006, Journal of abnormal psychology.

[13]  K. Perkins.  Combined effects of nicotine and alcohol on subjective, behavioral and physiological responses in humans , 1997, Addiction biology.

[14]  Rajita Sinha,et al.  Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo–pituitary–adrenocortical axis , 2002, Psychopharmacology.

[15]  K. Jackson,et al.  Prospective analysis of comorbidity: tobacco and alcohol use disorders. , 2000, Journal of abnormal psychology.

[16]  J. Kassel.  Substance abuse and emotion. , 2010 .

[17]  S. Shiffman,et al.  Progression from a smoking lapse to relapse: prediction from abstinence violation effects, nicotine dependence, and lapse characteristics. , 1996, Journal of consulting and clinical psychology.

[18]  R. Pihl,et al.  Nicotine increases alcohol self-administration in non-dependent male smokers. , 2006, Drug and alcohol dependence.

[19]  S. O'Malley,et al.  Modeling the effect of alcohol on smoking lapse behavior , 2006, Psychopharmacology.

[20]  C. Heyser,et al.  Neurocircuitry targets in ethanol reward and dependence. , 1998, Alcoholism, clinical and experimental research.

[21]  L Nadeau,et al.  Gender differences in alcohol consumption and adverse drinking consequences: cross-cultural patterns. , 2000, Addiction.

[22]  K. Berridge,et al.  The Neuroscience of Natural Rewards: Relevance to Addictive Drugs , 2002, The Journal of Neuroscience.

[23]  N. Benowitz,et al.  Additive cardiovascular effects of nicotine and ethanol , 1986, Clinical pharmacology and therapeutics.

[24]  S. Gulliver,et al.  Smoking Cessation and Alcohol Abstinence: What Do the Data Tell Us? , 2006, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[25]  J. Belluzzi,et al.  Acetaldehyde Enhances Acquisition of Nicotine Self-Administration in Adolescent Rats , 2005, Neuropsychopharmacology.

[26]  M. Jarvik,et al.  Combined use of alcohol and nicotine gum. , 1991, Addictive behaviors.

[27]  J. Mendelson,et al.  Cigarette smoking by women: interactions with alcohol use , 2005, Psychopharmacology.

[28]  Kenneth J Sher,et al.  The subjective effects of alcohol-tobacco co-use: an ecological momentary assessment investigation. , 2011, Journal of abnormal psychology.

[29]  A. King,et al.  Expanding the utility of the Biphasic Alcohol Effects Scale (BAES) and initial psychometric support for the Brief-BAES (B-BAES). , 2009, Alcoholism, clinical and experimental research.

[30]  R. Hinson,et al.  Survey of subjective effects of smoking while drinking among college students. , 2004, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[31]  M. Young,et al.  Tobacco chippers show robust increases in smoking urge after alcohol consumption , 2007, Psychopharmacology.

[32]  Megan E. Piper,et al.  Addiction motivation reformulated: an affective processing model of negative reinforcement. , 2004, Psychological review.

[33]  T. Baker,et al.  Postcessation cigarette use: the process of relapse. , 1990, Addictive behaviors.

[34]  C. Kahler,et al.  Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment. , 2010, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[35]  S. Cragg,et al.  Nicotine amplifies reward-related dopamine signals in striatum , 2004, Nature Neuroscience.

[36]  Todd M. Moore,et al.  Item functioning of the alcohol dependence scale in a high-risk sample. , 2003, Drug and alcohol dependence.

[37]  E. Kouri,et al.  Pretreatment with transdermal nicotine enhances some of ethanol's acute effects in men. , 2004, Drug and alcohol dependence.

[38]  S. Shiffman,et al.  First lapses to smoking: within-subjects analysis of real-time reports. , 1996, Journal of consulting and clinical psychology.

[39]  V. Pollock.  Meta-analysis of subjective sensitivity to alcohol in sons of alcoholics. , 1992, The American journal of psychiatry.

[40]  D. Drobes,et al.  Nicotine self‐medication of cognitive‐attentional processing , 2009, Addiction biology.

[41]  S. Tiffany,et al.  The effect of alcohol consumption on craving to smoke. , 1997, Addiction.

[42]  H A Skinner,et al.  Alcohol dependence syndrome: measurement and validation. , 1982, Journal of abnormal psychology.

[43]  K. Perkins,et al.  The influence of alcohol pre-treatment on the discriminative stimulus, subjective, and relative reinforcing effects of nicotine , 2005, Behavioural pharmacology.

[44]  J. West,et al.  Nicotine decreases blood alcohol concentrations in adult rats: a phenomenon potentially related to gastric function. , 2006, Alcoholism, clinical and experimental research.

[45]  Thomas R Kirchner,et al.  Patterns of intermittent smoking: An analysis using Ecological Momentary Assessment. , 2009, Addictive behaviors.

[46]  S. McKee,et al.  How can we use our knowledge of alcohol-tobacco interactions to reduce alcohol use? , 2013, Annual review of clinical psychology.

[47]  N. Martin,et al.  Alcohol sensitivity and smoking history in men and women. , 1995, Alcoholism, clinical and experimental research.

[48]  Kenneth J Sher,et al.  Adolescent alcohol and tobacco use: onset, persistence and trajectories of use across two samples. , 2002, Addiction.

[49]  B. Grant,et al.  Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. , 2004, Archives of general psychiatry.

[50]  D. Romberger,et al.  Smoking Cessation in Outpatient Alcohol Treatment , 2003 .

[51]  Dingcai Cao,et al.  Alcohol-induced increases in smoking behavior for nicotinized and denicotinized cigarettes in men and women , 2009, Psychopharmacology.

[52]  E. Diener,et al.  The independence of positive and negative affect. , 1984, Journal of personality and social psychology.

[53]  J. McGeary,et al.  Sex differences in stimulus expectancy and pharmacologic effects of a moderate dose of alcohol on smoking lapse risk in a laboratory analogue study , 2012, Psychopharmacology.

[54]  Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings. , 2001 .

[55]  D. Krahn,et al.  Development and initial validation of a measure of drinking urges in abstinent alcoholics. , 1995, Alcoholism, clinical and experimental research.

[56]  G F Koob,et al.  Neural mechanisms underlying nicotine addiction: acute positive reinforcement and withdrawal. , 2000, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[57]  Marcus R Munafò,et al.  Effects of acute nicotine and alcohol on the rating of attractiveness in social smokers and alcohol drinkers. , 2012, Drug and alcohol dependence.

[58]  S. O'Malley,et al.  Smoking status as a clinical indicator for alcohol misuse in US adults. , 2007, Archives of internal medicine.

[59]  M. Marmot,et al.  Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations , 2004, Journal of Epidemiology and Community Health.

[60]  S. Glautier,et al.  Dissociation of wanting and liking for alcohol in humans: a test of the incentive-sensitisation theory , 2005, Psychopharmacology.

[61]  M. Sayette,et al.  The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers. , 2005, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[62]  C. Kahler,et al.  Pharmacological effects of naltrexone and intravenous alcohol on craving for cigarettes among light smokers: a pilot study , 2007, Psychopharmacology.

[63]  H Wechsler,et al.  Correlates of college student binge drinking. , 1995, American journal of public health.

[64]  Ashley Acheson,et al.  Differential effects of nicotine on alcohol consumption in men and women , 2006, Psychopharmacology.

[65]  M. First,et al.  Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet , 1997 .

[66]  Sarah M. Scholl,et al.  Characteristics and smoking patterns of intermittent smokers. , 2012, Experimental and clinical psychopharmacology.

[67]  D. Drobes.  Cue reactivity in alcohol and tobacco dependence. , 2002, Alcoholism, clinical and experimental research.

[68]  L. Brauer,et al.  Psychopharmacological interactions between nicotine and ethanol. , 2004, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[69]  M. L. Cooper,et al.  Drinking to regulate positive and negative emotions: a motivational model of alcohol use. , 1995, Journal of personality and social psychology.

[70]  M. Sayette,et al.  Experimental design in alcohol administration research: limitations and alternatives in the manipulation of dosage-set. , 1993, Journal of studies on alcohol.

[71]  T. Cooper,et al.  Preliminary findings on the interactive effects of IV ethanol and IV nicotine on human behavior and cognition: a laboratory study. , 2012, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[72]  L. Kozlowski,et al.  The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. , 1991, British journal of addiction.