Over 85% of alcoholics smoke, most are heavy smokers and many die of smoking-related illnesses. Despite the recent interest of both patients and clinicians, experimental studies of treatment for smoking cessation among alcoholics are lacking. A post-hoc finding in an earlier study of ours suggests recovering alcoholic smokers are more dependent on and are especially benefitted by nicotine replacement therapy. We propose to prospectively test this finding by randomly assigning recovering alcoholics to group behavior therapy plus either nicotine or placebo transdermal patches in a double-blind manner. 200 Ss at two sites (VT & MN) will receive daily patches and weekly group therapy for 12 was. Biochemically verified smoking abstinence and observer- and self-ratings of nicotine withdrawal and craving will be obtained. These results with recovering alcoholics will be compared with those from smokers drawn from the general population who were tested with the exact same patch and protocol in an earlier study. We will also compare desire for alcohol and confidence in not relapsing back to drinking between our recovering alcoholics who are abstinent from smoking with a group of recovering alcoholic smokers who are not trying to stop smoking. Post-hoc analyses will be used to estimate the optimal timing pose-drinking for smoking cessation to occur. This trial will provide initial information on whether 1) transdermal nicotine plus group behavior therapy is an effective treatment for smoking cessation in recovering alcoholics, 2) recovering alcoholics are less likely to stop smoking in a smoking cessation program than smokers in the general population, 3) stopping smoking increases desire to drink alcohol or decreases confidence in not relapsing to alcohol, and 4) it is better to attempt smoking cessation soon after or long after achieving sobriety. Positive results would encourage recovering alcoholics to enter and their counselors to provide smoking cessation treatment.
| Hughes, J R; Oliveto, A H; MacLaughlin, M (2000) Is dependence on one drug associated with dependence on other drugs? The cases of alcohol, caffeine and nicotine. Am J Addict 9:196-201 |
| Hughes, J R; Liguori, A (1997) Bibliographical analysis of research on smoking cessation therapy. Tob Control 6:111-4 |
| Hughes, J R (1996) The future of smoking cessation therapy in the United States. Addiction 91:1797-802 |
| Hughes, J R; Frances, R J (1995) How to help psychiatric patients stop smoking. Psychiatr Serv 46:435-6 |
