Skip to main content

Advertisement

SpringerLink
Log in

Modeling the effect of alcohol on smoking lapse behavior

  • Original Investigation
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

Objective

The primary aim of this project was to examine the role of alcohol use in smoking lapse behavior, as alcohol consumption is a known risk factor for poor smoking cessation outcomes.

Materials and methods

We have developed a novel human laboratory model to examine two primary aspects of alcohol-mediated tobacco relapse: (1) Does alcohol facilitate the initiation of the first cigarette? (2) Once the first cigarette is initiated, does alcohol facilitate subsequent smoking? Using a within-subject design, 16 daily smokers who were also heavy social drinkers received a priming drink (0.03 g/dl or taste-masked placebo) and then had the option of initiating a tobacco self-administration session or delaying initiation by 5-min increments for up to 50 min in exchange for monetary reinforcement. Subsequently, the tobacco self-administration session consisted of a 1-h period in which subjects could choose to smoke their preferred brand of cigarettes using a smoking topography system or receive monetary reinforcement for cigarettes not smoked. Alcohol craving, tobacco craving, subjective reactivity to alcohol, and nicotine withdrawal were assessed as secondary outcomes.

Results

Results demonstrated that after consuming the alcohol beverage, subjects were less able to resist the first cigarette and initiated their smoking sessions sooner, and smoked more cigarettes compared to the placebo beverage. These findings have implications for smoking cessation in alcohol drinkers and model development to assess smoking lapse behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. There were 13 subjects available for these analyses. Two subjects did not smoke for at least one of their topography sessions, and there was equipment failure for a third subject.

  2. For one subject, there was disagreement between the recorded number of cigarettes smoked and the number recorded by the smoking topography equipment. As there was no equipment failure, we elected to use the data generated by the topography equipment.

References

  • Babor TF, de la Fuente JR, Saunders J, Grant M (1992) AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care. World Health Organization, Geneva, Switzerland

    Google Scholar 

  • Baer JS, Lichenstein E (1988) Classification and prediction of smoking relapse episodes: an exploration of individual differences. J Consult Clin Psychol 56:104–110

    Article  PubMed  CAS  Google Scholar 

  • Bartoshuk LM (2002) Comparing sensory experiences across individuals: recent psychophysical advances illuminate genetic variation in taste perception. Chem Senses 25:447–460

    Article  Google Scholar 

  • Bohn MJ, Krahn DD, Staehler BA (1995) Development and initial validation of a measure of drinking urges in abstinent alcoholics. Alcohol Clin Exp Res 19:600–606

    Article  PubMed  CAS  Google Scholar 

  • Brandon TH, Tiffany ST, Obremski KM, Baker TB (1990) Postcessation cigarette use: the process of relapse. Addict Behav 15:105–114

    Article  PubMed  CAS  Google Scholar 

  • Burton SM, Tiffany ST (1997) The effect of alcohol consumption on craving to smoke. Addiction 92:15–26

    Article  PubMed  CAS  Google Scholar 

  • Center for Disease Control and Prevention (CDC) (2003) Cigarette smoking among adults—United States 2001. MMWR Morb Mortal Wkly Rep 52(40):953–956

    Google Scholar 

  • Carmody TP, Brishchetter CS, Matarazzo JD (1985) Co-occurent use of cigarettes, alcohol and coffee in healthy community living men and women. Health Psychol 4:323–335

    Article  PubMed  CAS  Google Scholar 

  • Carter BL, Tiffany ST (1999) Meta-analysis of cue reactivity in addiction research. Addiction 94:327–340

    Article  PubMed  CAS  Google Scholar 

  • Chornock WM, Stitzer ML, Gross J, Leischow S (1992) Experimental model of smoking re-exposure: effects on relapse. Psychopharmacology 108:495–500

    Article  PubMed  CAS  Google Scholar 

  • Cox LS, Tiffany ST, Christen AG (2001) Evaluation of the brief questionnaire of smoking urges (QSU-Brief) in laboratory and clinical settings. Nicotine Tob Res 3:7–16

    Article  PubMed  CAS  Google Scholar 

  • Daeppen J, Smith TL, Danko GP, Gordon L, Landi NA, Nurnberger JI, Ducholz KK, Raimo E, Schuckit MA, The Collaborative Study Group on the Genetics of Alcoholism (2000) Clinical correlates of cigarette smoking and nicotine dependence in alcohol dependent men and women. Alcohol Alcohol 35:171–175

    PubMed  CAS  Google Scholar 

  • DiFranza JR, Guerrera MP (1990) Alcoholism and smoking. J Stud Alcohol 51:130–135

    PubMed  CAS  Google Scholar 

  • Drobes DJ, Beylotte F, Scott M, Saladin ME, Randell CL, Anton RF (2000) Cross-reactivity to alcohol and smoking cues. Alcohol Clin Exp Res 24:147a

    Google Scholar 

  • Ellingstad TP, Sobell LC, Sobell MB, Cleland PA, Agrawal S (1999) Alcohol abusers who want to quit smoking: implications for clinical treatment. Drug Alcohol Depend 54:259–264

    Article  PubMed  CAS  Google Scholar 

  • Fiore MC, Bailey WC, Cohen SJ et al (2000) Treating tobacco use and dependence. Clinical practice guideline. U.S. Department of Health and Human Services. Public Health Service, Rockville, MD

    Google Scholar 

  • First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV, patient edition. American Psychiatric Press, Washington, D.C.

    Google Scholar 

  • Garvey A, Bliss R, Hitchcock J, Heinold J, Rosner B (1992) Predictors of smoking relapse among self-quitters: a report from the normative aging study. Addict Behav 17:367–377

    Article  PubMed  CAS  Google Scholar 

  • Gilbert DF, Crauthers DM, Mooney DK, McClernon FJ, Jensen RA (1999) Effects of monetary contingencies on smoking relapse: influences of trait depression, personality, and habitual nicotine intake. Exp Clin Psychopharmacol 7:174–181

    Article  PubMed  CAS  Google Scholar 

  • Glautier S, Clements K, White JA, Taylor C, Stolerman IP (1996) Alcohol and the reward value of cigarette smoking. Behav Pharmacol 7:144–154

    Article  PubMed  CAS  Google Scholar 

  • Grant BF, Hasin DS, Chou PS, Stinson FS, Dawson DA (2004) Nicotine dependence and psychiatric disorders in the United States. Arch Gen Psychiatry 61:1107–1115

    Article  PubMed  Google Scholar 

  • Griffiths RR, Bigelow GR, Liebson I (1976) Facilitation of human tobacco self-administration by ethanol: a behavioral analysis. J Exp Anal Behav 25:279–292

    Article  PubMed  CAS  Google Scholar 

  • Gulliver SB, Rohsenow DJ, Colby SM, Dey AN, Abrams DB et al (1995) Interrelationship of smoking and alcohol dependence. J Stud Alcohol 56:202–206

    PubMed  CAS  Google Scholar 

  • Hariharan M, Van Noord T, Greden JF (1988) A high performance liquid chromatographic method for routine simultaneous determination of nicotine and cotinine in plasma. Clin Chem 34:724–729

    PubMed  CAS  Google Scholar 

  • Hatsukami DK, Hurghes JF, Pickens RW, Svikis D (1984) Tobacco withdrawal symptoms: an experimental analysis. Psychopharmacology 84:231–236

    Article  PubMed  CAS  Google Scholar 

  • Hatsukami D, Lexau G, Nelson D, Pentel PR, Sofuoglu M, Goldman A (1998) Effects of cotinine on cigarette self-administration. Psychopharmacology 138:184–189

    Article  PubMed  CAS  Google Scholar 

  • Hayford KE, Patten CA, Rummans TA, Schroeder DR, Offord KP et al (1999) Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psychiatry 174:173–178

    Article  PubMed  CAS  Google Scholar 

  • Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom K (1991) The Fagerstrom Test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 86:1119– 1127

    Article  PubMed  CAS  Google Scholar 

  • Henningfield JE, Chait LD, Griffiths RR (1984) Effects of ethanol on cigarette smoking volunteers without histories of alcoholism. Psychopharmacology 82:1–5

    Article  PubMed  CAS  Google Scholar 

  • Higgins ST (1997) The influence of alternative reinforcers on cocaine use and abuse: a brief review. Pharmacol Biochem Behav 57(3):419–427

    Article  PubMed  CAS  Google Scholar 

  • Hughes JR (1993) Treatment of smoking cessation in smokers with past alcohol/drug problems. J Subst Abuse Treat 10:181–187

    Article  PubMed  CAS  Google Scholar 

  • Hughes JF, Hatsukami D (1986) Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry 43:289–294

    PubMed  CAS  Google Scholar 

  • Hurt RD, Eberman KM, Croghan IT, Offord KP, Davis LJ et al (1994) Nicotine dependence treatment during inpatient treatment for other addictions: a prospective intervention trial. Alcohol Clin Exp Res 4:867–872

    Article  Google Scholar 

  • Istvan J, Matarazza JD (1984) Tobacco, alcohol, and caffeine use: a review of their interrelationships. Psychol Bull 95:301–326

    Article  PubMed  CAS  Google Scholar 

  • Juliano LM, Donny EC, Stitzer ML (2003) Subjective and physiological reactions to smoking a nicotine or de-nicotinized cigarette after a brief period of abstinence. The 9th annual convention of the Society for Research on Nicotine and Tobacco. New Orleans, Louisiana

  • Kalman D, Morissette SB, George TP (2005) Co-morbidity of smoking in patients with psychiatric and substance use disorders. Am J Addict 14:106–123

    Article  PubMed  Google Scholar 

  • Kenford SL, Fiore MC, Jorenby DW, Smith SS, Wetter D, Baker TB (1994) Predicting smoking cessation. Who will quit with and without the nicotine patch. JAMA 27:589–594

    Article  Google Scholar 

  • King AC, Houle T, de Wit H, Holdstock L, Schuster A (2002) Biphasic alcohol response differs in heavy versus light drinkers. Alcohol Clin Exp Res 26:827–835

    Article  PubMed  CAS  Google Scholar 

  • King AC, Meyer PJ (2000) Naltrexone alteration of acute smoking response in nicotine-dependent subjects. Pharmacol Biochem Behav 66:563–572

    Article  PubMed  CAS  Google Scholar 

  • King AC, Epstein AM (2005) Alcohol dose-dependent increases in smoking urge in light smokers. Alcohol Clin Exp Res 29:547–552

    Article  PubMed  Google Scholar 

  • Kouri EM, McCarthy EM, Faust AH, Lukas SE (2004) Pretreatment with transdermal nicotine enhances some of ethanol’s acute effects in men. Drug Alcohol Depend 75:55–65

    Article  PubMed  CAS  Google Scholar 

  • Marlatt GA, Curry S, Gordon JR (1988) A longitudinal analysis of unaided smoking cessation. J Consult Clin Psychol 56:715–720

    Article  PubMed  CAS  Google Scholar 

  • Martin CS, Earleywine M, Musty RE, Perrine MW, Swift RM (1993) Development and validation of the Biphasic Alcohol Effects Scale Alcoholism. Alcohol Clin Exp Res 17:140–146

    Article  PubMed  CAS  Google Scholar 

  • Mello NK, Mendelson JH, Palmieri SL (1987) Cigarette smoking by women: interactions with alcohol use. Psychopharmacology 93:8–15

    Article  PubMed  CAS  Google Scholar 

  • Mintz J, Boyd G, Rose JE, Charuvastra VC, Jarvik MC (1985) Alcohol increases cigarette smoking: a laboratory demonstration. Addict Behav 10:203–207

    Article  PubMed  CAS  Google Scholar 

  • Mitchell SH, deWit H, Zacny JP (1995) Effects of varying ethanol dose of cigarette consumption in healthy normal volunteers. Behav Pharmacol 6:359–365

    PubMed  CAS  Google Scholar 

  • Niaura R, Abrams D, Demuth B, Pinto R, Monti P (1989) Responses to smoking-related stimuli and early relapse to smoking. Addict Behav 14:419–428

    Article  PubMed  CAS  Google Scholar 

  • Nides M, Rakos R, Gonzales D, Murray R, Tashkin D, Bjornson-Benson W, Lindgren P, Connett J (1995) Predictors of initial smoking cessation and relapse through the first two years of the Lung Health Study. J Consult Clin Psychol 63:60–69

    Article  PubMed  CAS  Google Scholar 

  • Norregaard J, Tonnesen P, Petersen L (1993) Predictors and reasons for relapse in smoking cessation with nicotine and placebo patches. Prev Med 22:261–271

    Article  PubMed  CAS  Google Scholar 

  • O’Malley SS, Krishnan-Sarin S, Farren C, Sinha R, Kreek J (2002) Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo–pituitary–adrenocortical axis. Psychopharmacology 160:19–29

    Article  PubMed  CAS  Google Scholar 

  • Patten CA, Martin JE, Owen N (1996) Can psychiatric and chemical dependency treatment units be smoke free? J Subst Abuse Treat 13:107–118

    Article  PubMed  CAS  Google Scholar 

  • Perkins KA, Saners M, D’Amico D, Wilson A (1997) Nicotine discrimination and self-administration in humans as a function of smoking status. Psychopharmacology 131:361–370

    Article  PubMed  CAS  Google Scholar 

  • Perkins KA, Fonte C, Sanders M, White W, Wilson A (1999) Effects of training dose and two- versus three-choice testing procedure on nicotine discrimination in humans. Psychopharmacology 145:418–425

    Article  PubMed  CAS  Google Scholar 

  • Perkins KA, Levine M, Marcus M, Shiffman S, D’Amico D, Miller A, Keins A, Ashcom J, Broge M (2000) Tobacco withdrawal in women and menstrual cycle phase. J Consult Clin Psychol 68:176–180

    Article  PubMed  CAS  Google Scholar 

  • Perkins KA, Fonte C, Meeker J, White W, Wilson W (2001) The discriminative stimulus and reinforcing effects of nicotine in humans following nicotine pretreatment. Behav Pharmacol 12:35–44

    PubMed  CAS  Google Scholar 

  • Perkins KA, Stitzer M, Lerman C (2006) Medication screening for smoking cessation: a proposal for new methodologies. Psychopharmacology 184:628–636

    Article  PubMed  CAS  Google Scholar 

  • Rodefer JS, Mattox AJ, Thompson SS, Carroll ME (1997) Effects of buprenorphine and an alternative nondrug reinforcer, alone and in combination on smoked cocaine self-administration in monkeys. Drug Alcohol Depend 45:21–29

    Article  PubMed  CAS  Google Scholar 

  • Rose JE, Brauer LH, Behm FM, Cramblett M, Calkins K, Lawhon D (2004) Psychopharmacological interactions between nicotine and ethanol. Nicotine Tob Res 6:133–144

    Article  PubMed  CAS  Google Scholar 

  • Rosengren A, Wilhelmsen L, Wedel H (1993) Separate and combined effects of smoking and alcohol abuse in middle-aged men. Acta Med Scand 223:111–118

    Article  Google Scholar 

  • Sayette MA, Martin CS, Wertz JM, Shiffman SS, Perrott MA (2001) A multi-dimensional analysis of cue-elicited craving in heavy smokers and tobacco chippers. Addiction 96:1419–1432

    Article  PubMed  CAS  Google Scholar 

  • Sayette MA, Martin CS, Wertz JM, Perrott MA, Peters AR (2005) The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers. Psychol Addict Behav 19:263–270

    Article  PubMed  Google Scholar 

  • Schuckit M (1984) Subjective responses to alcohol in sons of alcoholics and control subjects. Arch Gen Psychiatry 41:879–885

    PubMed  CAS  Google Scholar 

  • Shiffman S (1986) A cluster-analysis classification of smoking relapse episodes. Addict Behav 11:292–307

    Article  Google Scholar 

  • Shiffman S, Balabanis M (1995) Associations between alcohol and tobacco. In: Fertig JB, Allen JP (eds) Alcohol and tobacco: from basic science to clinical practice (vol 30, Research Monograph Series, pp 17–36). National Institutes of Health, Washington, DC

    Google Scholar 

  • Shiffman SM, Fischer LA, Paty J, Gnys M, Hickcox M, Kassel JD (1994) Drinking and smoking: a field study of their association. Annals Behav Med 16:203–209

    Google Scholar 

  • Shiffman S, Paty JA, Gnys M, Kassel JA, Hickcox M (1996) First lapses to smoking: within-subjects analysis of real-time reports. J Consult Clin Psychol 64:366–379

    Article  PubMed  CAS  Google Scholar 

  • Shiffman S, Engberg JB, Paty JA, Perz WG, Gnys M, Kassel JD, Hickcox M (1997) A day at a time: predicting smoking lapse from daily urge. J Abnorm Psychol 106:104–116

    Article  PubMed  CAS  Google Scholar 

  • Sobell LC, Sobell MB (1993) Timeline Followback: a technique for assessing self-reported ethanol consumption. In: Allen J, Litten R (eds) Techniques to assess alcohol consumption. Humana Press, New Jersey

    Google Scholar 

  • Sobell LC, Sobell MB, Kozlowski LT, Toneatto T (1990) Alcohol or tobacco research versus alcohol and tobacco research. Br J Addict 85:263–269

    Article  PubMed  CAS  Google Scholar 

  • Sobell MB, Sobell LC, Kozlowski LT (1995) Dual recoveries from alcohol and smoking problems. In: Fertig JB, Allen JP (eds) Alcohol and tobacco: from basic science to clinical practice. National Institutes of Health, Bethesda, MD, pp 207–224

    Google Scholar 

  • Stitzer ML, Rand CS, Below GE, Mead AM (1986) Contingent payment procedures for smoking reduction and cessation. J Appl Behav Anal 19:197–202

    Article  PubMed  CAS  Google Scholar 

  • Tiffany ST (1995) Potential functions of classical conditioning in drug addiction. In: Drumond DC, Tiffany ST, Glautier SP, Remington B (eds) Addictive behavior: cue exposure, theory, and practice. Wiley, London, pp 47–71

    Google Scholar 

  • Watson PE (1989) Total body water and blood alcohol levels: updating the fundamentals. In: Crow KE, Batt Rd (eds) Human metabolism of alcohol, vol I. CRC Press, Boca Raton, FL, pp 41–56

    Google Scholar 

  • Westman EC, Behm FM, Simel DL, Rose JE (1997) Smoking behavior on the first day of a quit attempt predicts long-term abstinence. Arch Intern Med 157:335–340

    Article  PubMed  CAS  Google Scholar 

  • Zimmerman RS, Warheit GJ, Ulbrich PM, Auth JB (1990) The relationship between alcohol use and attempts and success at smoking cessation. Addict Behav 15:197–207

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. Peter Jatlow, PI of the Laboratory Core (P50AA015632), for analyzing the nicotine plasma samples. Funding was provided by grants P50DA13334, P50AA015632, R03AA013622, and M01RR000125.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center-CMHC, 34 Park St., Suite S-211, New Haven, CT, 06519, USA

    Sherry A. McKee, Suchitra Krishnan-Sarin, Tricia Mase & Stephanie S. O’Malley

  2. Department of Internal Medicine, Yale University School of Medicine, 495 Congress Avenue, #3, New Haven, CT, 06519, USA

    Julia Shi

Authors
  1. Sherry A. McKee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suchitra Krishnan-Sarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julia Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tricia Mase
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephanie S. O’Malley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sherry A. McKee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McKee, S.A., Krishnan-Sarin, S., Shi, J. et al. Modeling the effect of alcohol on smoking lapse behavior. Psychopharmacology 189, 201–210 (2006). https://doi.org/10.1007/s00213-006-0551-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-006-0551-8

Keywords

Search

Navigation