The long-term objective of this research is to enhance cross-addictions treatment recommendations by elucidating the relationship between smoking and drinking among alcoholics under carefully controlled experimental conditions. Findings will contribute both to our basic knowledge concerning some of the relationships between drinking and smoking and to knowledge about factors that are likely to increase or decrease the probability of relapse.
The specific aims are to: 1) investigate alcoholics' expectancies about the interaction of smoking with drinking and with alcohol treatment, and to relate the expectancies to post-treatment substance use, 2) investigate the effects of smoking on reactions such as urges to drink elicited in response to alcohol cues, and 3) investigate the effects of the reactivity to alcohol cues on subsequent smoking rate. Three studies are planned. Study 1 will use interviews and questionnaires to assess expectancies about the effects of smoking, of drinking, of the interaction of smoking and urges to drink, and beliefs about the effects of smoking and of smoking cessation on the process of recovery from alcohol treatment. Data on smoking and drinking rates will be obtained both during treatment and at 3 month follow-up so that the expectancies can be related to short-term change in drinking and smoking rates. In Study 2, urges to drink and other aspects of cue reactivity will be elicited by exposing alcoholics to alcohol cues (a control group will be exposed only to water cues), then subjects will either smoke their usual cigarette or only read magazines in order to determine the effects of smoking on elicited cue reactivity. In a third study the effect of alcohol reactivity on smoking will be assessed by exposing alcoholics to either alcohol or water cues, then assessing the subsequent rate and topography of smoking. Assessments of alcohol reactivity in these studies will include both self report and psychophysiological measures. Assessments of smoking will include topography, rate, and expired alveolar carbon monoxide. Individual difference factors will be assessed to investigate mediating variables. Results of these studies will provide groundwork for making more informed decisions as to whether it would be more effective to encourage alcoholics to quit smoking concurrently with alcoholism treatment or wait until sobriety is stabilized. Furthermore, individuals may be identified who could be matched to immediate versus delayed smoking interventions, and expectancies about the interaction of tobacco and alcohol can be targeted for modification in treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA008734-04
Application #
2044784
Study Section
Clinical and Treatment Subcommittee (ALCP)
Project Start
1991-09-01
Project End
1996-08-31
Budget Start
1994-09-01
Budget End
1995-08-31
Support Year
4
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Brown University
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
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Kalman, D; Hayes, K; Colby, S M et al. (2001) Concurrent versus delayed smoking cessation treatment for persons in early alcohol recovery. A pilot study. J Subst Abuse Treat 20:233-8
Gulliver, S B; Kalman, D; Rohsenow, D J et al. (2000) Smoking and drinking among alcoholics in treatment: cross-sectional and longitudinal relationships. J Stud Alcohol 61:157-63
Kalman, D (1998) Smoking cessation treatment for substance misusers in early recovery: a review of the literature and recommendations for practice. Subst Use Misuse 33:2021-47
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Palfai, T P; Monti, P M; Colby, S M et al. (1997) Effects of suppressing the urge to drink on the accessibility of alcohol outcome expectancies. Behav Res Ther 35:59-65
Gulliver, S B; Rohsenow, D J; Colby, S M et al. (1995) Interrelationship of smoking and alcohol dependence, use and urges to use. J Stud Alcohol 56:202-6
Monti, P M; Gulliver, S B; Myers, M G (1994) Social skills training for alcoholics: assessment and treatment. Alcohol Alcohol 29:627-37