Amanda St.Pierre
 

 mail to: alstp@earthlink.net
 

 Can Mere Exposure to Alcohol Trigger Nicotine Cravings
Background Research Question Method
Results Implications Relevant Links


Background
As our society expands in numbers, dilemmas become prevalent. One notable issue deals with the habit forming substance use of alcohol and tobacco. Alcohol and tobacco consumption in college students is a growing problem in our society. Research has shown a relationship between alcohol and amount of nicotine that is consumed in alcoholic adults (Batel & Pessione, 1995; Gulliver, Rohesenow, Colby, Dey, Abrams, Niaura & Monti, 1995). Research shows that alcoholics smoke at a rate that is about three times higher than the population as a whole (Patten, Martin, & Owen, 1996).  In addition 70% of drinkers are heavy smokers (Collins, 1995). Factors that contribute to college drinking and smoking include desire for alleviation of stress, peer pressure, social acceptance, family history of drug use, economic status, social norms and wanting to appear mature (Lichtenfeld & Kayson, 1994; "Action on smoking and health", 1999). 
In a study conducted by Gulliver and colleagues (Gulliver, S.B., Rohsenow, D.J., Colby, S. M., Dey, A.N., Abrams, D.B, Niaura, R.S., & Monti, P.M., 1993) the interrelationships of smoking and alcohol dependence and the relationship between the presence of alcohol and urge to smoke were examined. The study used the Fagerstrom Tolerance Questionnaire to measure tobacco dependence and the Alcohol Dependence Scale and A cue reactivity assessment was used to determine the relationship between urge to smoke in presence of alcohol. The results of the study showed that smoking rate and the tobacco dependence were significantly correlated with alcohol dependence. The results also showed that there was a positive correlation between urge to drink and urge to smoke. 
Nicotine and alcohol often occur concurrently, both in terms of consumption at the same time and constant consumers of one tend to be constant consumers of the other.  Two hypotheses that try to explain this relationship are the social cognitive apprenticeship hypothesis and the psychological compensation hypothesis. According to the social cognitive apprenticeship hypothesis the two needs may result from alcohol inciting a desire for nicotine and vice versa. Each one serves as a stimulus for the other. The psychological compensation hypothesis believes that smoking may help to relieve the negative effects of depression and anxiety that can be associated with heavy drinking (Gulliver, Rohesenow, Colby, Dey, Abrams, Niaura & Monti, 1995). 
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Research Question
 This study has two specific goals. First, it will examine the relationship between alcohol and nicotine intake in a college population. Second, it will examine if exposure to alcohol will trigger nicotine cravings. It is hypothesized that (1) alcohol consumption will increase amount of cigarettes smoked and (2) exposure to alcohol will increase urge to smoke. 
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Method

A total of 44 participants were recruited (24 females and 20 males) from the general psychology subjects pool of a small northeastern liberal arts college. 
The materials used for this study are; The Student Alcohol Questionnaire, a self report measure developed by, Engs (1997), The Fagerstrom Tolerance Questionnaire (FTQ), developed by Fagerstrom (1999) to measure nicotine dependence (FTND) and heaviness of smoking index (HIS), and the cue activity assessment, which assesses if the presence of alcohol induces cravings for nicotine.
The participants first completed the Fagerstrom questionnaire and the student alcohol questionnaire. 
 The participants were next split into four groups of 11. Each group was given a different concentration of peppermint listerine. Each participant in the group was then asked to smell the listerine concentration for three minutes and rate their craving for nicotine on a scale of 1-5. One being no craving, two being slight craving, three being craving, four being strong craving and five being very strong craving. After the cue reactivity assessment was finished the participants received a debriefing form (See Appendix A) explaining to them all about the study. 

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Results
The results replicate previous findings (Gulliver et al., 1993; Batel & Pessione, 1995) to the degree that alcohol consumption is correlated with tobacco consumption.  Strong evidence was provided that alcohol consumption and tobacco use have a strong relationship. This relationship was found by questionnaires which obtained information about amount of alcohol consumed a week and amount of cigarettes consumed a week. In previous studies (Gulliver et al., 1993; Batel & Pessione, 1995; DiFranza & Guerrera, 1990) a clear relationship was shown between alcoholism and tobacco use. These findings suggest that heavy tobacco use can be an early indicator of alcoholism.
The results also provided clear evidence that the presence of different alcohol concentrations increased craving to smoke in cigarette smokers. This significance was found on ratings obtained from a cue reactivity assessment. The two higher alcohol concentrations showed no significant results. This finding could be due to the fact that the powerful mint smell of the listerine was so strong in these concentrations that it made the participants ill to smell it for three minutes. Gulliver and Colleagues believe that a learned association between smoking and drinking could explain the relationship between urge to smoke in response to alcohol behavior cues. 
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Implications

Gulliver and colleagues (1995) as well as Perkins (1997) attempt to explain the relationship between alcohol consumption and tobacco use with a common theory. The theory being that nicotine implements the individuals to consume alcohol without experiencing some of the adverse effects, mainly depression and anxiety, but at the same time retaining the initial arousing mood effects. Gulliver and colleagues also believe that this relationship may trigger similar opioid peptide responses as a coping response, or form of self medication.
According to Burton and Tiffany (1997) the finding that alcohol enhances craving to smoke correlates with other data indicating that alcohol consumption is strongly affiliated with smoking relapse in ex-smokers. 
Burton and Tiffany go on to say that once alcohol is initiated as a smoking cue, it is difficult for abstinent smokers to avoid . Two findings were contrived from this research. First, alcohol consumption and cigarette smoking showed a strong correlation. Specifically, alcohol consumption and cigarette smoking have a positive relationship, because this study was correlational it should not be taken as evidence of a causal relationship. Second, presence of alcohol showed to increase urge to smoke in smokers.
What the findings of this study and the above information implicates, is that the combined use of smoking and alcohol consumption are dependent on one another and that those who abuse one substance are likely to become abusers of the other.

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Relevant Links

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