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.
