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Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

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Abstract

Rationale

Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior.

Objective

The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior.

Materials and methods

Subjects (n = 19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed.

Results

We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch.

Conclusions

In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.

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References

  • Acheson A, Mahler SV, Chi H, de Wit H (2006) Differential effects of nicotine on alcohol consumption in men and women. Psychopharmacology 186:54–63

    Article  PubMed  CAS  Google Scholar 

  • Anton RF, Dorbes DJ, Voronin K, Durazo-Avizu R, Moak D (2004) Naltrexone effects on alcohol consumption in a clinical laboratory paradigm: temporal effects of drinking. Psychopharmacology 173:32–40

    Article  PubMed  CAS  Google Scholar 

  • 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

  • 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 

  • Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182

    Article  PubMed  CAS  Google Scholar 

  • Barrett SP, Tichauer M, Leyton M, Pihl RO (2006) Nicotine increases alcohol self-administration in non-dependent male smokers. Drug Alcohol Depend 81:197–204

    Article  PubMed  CAS  Google Scholar 

  • Benowitz NL, Jones RT, Jacob III P (1986) Additive cardiovascular effect of nicotine and ethanol. Clin Pharmacol Ther 40:420–424

    Article  PubMed  CAS  Google Scholar 

  • Blomqvist O, Ericson M, Johnson DH, Engel JA, Sodepalm B (1996) Voluntary ethanol intake in the rat: effects of nicotinic acetylcholine receptor blockade or subchronic nicotine treatment. Eur J Pharmacol 314:257–267

    Article  PubMed  CAS  Google Scholar 

  • Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS et al (1988) Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 48:3282–3287

    PubMed  CAS  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 

  • Burling TA, Marshall GD, Seidner A (1991) Smoking cessation for substance abuse inpatients. J Subst Abuse 3:269–276

    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 

  • Clark A, Lindgren S, Brooks SP, Watson WP, Little HJ (2001) Chronic infusion of nicotine can increase operant self-administration of alcohol. Neuropharmacology 41:108–117

    Article  PubMed  CAS  Google Scholar 

  • Colby SM, Rohsensow DJ, Monti PM, et al (2004) Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults. Addict Behav 29:879–892

    Article  PubMed  Google Scholar 

  • Cooney NL, Litt MD, Cooney JL, Oncken CA, Pilkey DT, Findley J (2001) Ecological momentary assessment of smoking cessation in alcoholic smokers. Paper Presented at the Annual Meeting of the Society for Research on Nicotine and Tobacco, Seattle, WA

  • Cooney JL, Cooney NL, Pilkey DT, Kranzler HR, Oncken CA (2003) Effects of nicotine deprivation on urges to drink and smoke in alcoholic smokers. Addiction 98:913–921

    Article  PubMed  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 

  • Epstein AM, Sher TG, Young AA, King AC (2007) Tobacco chippers show robust increases in smoking urge after alcohol consumption. Psychopharmacology 190:321–329

    Article  PubMed  CAS  Google Scholar 

  • First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV, Patient Edition. American Psychiatric Press, Washington DC

    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 

  • 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 

  • Gupta SK, Benowitz NL, Jacob P, Gorsline A (1993) Bioavailability and absorption kinetics of nicotine following application of transdermal system. Br J Pharmacol 36:221–227

    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 

  • 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 Psychol 174:173–178

    Article  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 (1995) Clinical implications of the association between smoking and alcoholism. In: Fertig J, Fuller R (eds) Alcohol and tobacco: from basic science to policy, NIAAA research monograph 30. National Institute on Alcoholism and Alcohol Abuse, Rockville, MD, pp 171–185

    Google Scholar 

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

    PubMed  CAS  Google Scholar 

  • Hughes JR, Callas PW, High Dose Study Group (2003) Past alcohol problems do not predict worse smoking cessation outcomes. Drug Alcohol Depend 71:269–273

    Article  PubMed  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 

  • Hurt RD, Dale LC, Offord KP, Croghan IT, Hays JT, Gomez-Dahl L (1995) Nicotine patch therapy for smoking cessation in recovering alcoholics. Addiction 90:1541–1546

    Article  PubMed  CAS  Google Scholar 

  • Hurt RD, Offord KP, Croghan IT, Gomez-Dahl L, Kottke TE, Morse RM, Melton J (1996) Mortality following inpatient addictions treatment: role of tobacco use in a community-based cohort. JAMA 275:1097–1103

    Article  PubMed  CAS  Google Scholar 

  • Institute of Medicine (1990) Broadening the base of treatment for alcohol problems. National Academy Press, Washington, DC

    Google Scholar 

  • Joseph AM, Nicol KL, Willenbring ML, Korn JE, Lysaght LS (1990) Beneficial effects of treatment of nicotine dependence during an inpatient substance abuse treatment program. J Am Med Assoc 263:3043–3046

    Article  CAS  Google Scholar 

  • Katner SN, McBride WJ, Lumeng L, Li T-K, Murphy JM (1997) Involvement of CNS cholinergic systems in alcohol drinking of P rats. Addict Biol 2:215–233

    Article  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 

  • Klatsky AL, Armstrong MA (1992) Alcohol, smoking, coffee, and cirrhosis. Am J Epidemiol 136:1248–1257

    PubMed  CAS  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 

  • Krishnan-Sarin S, Krystal JH, Shi J, Pittman B, O'Malley SS (2007) Family history of alcoholism influences naltrexone-induced reduction in alcohol drinking. Biol Psychiatry 62:694–697

    Article  PubMed  CAS  Google Scholar 

  • Lê AD, Corrigall WA, Harding JW, Juzytsch W, Li TK (2000) Involvement of nicotine receptors in alcohol self-administration. Alcohol Clin Exp Res 24:155–163

    Article  PubMed  Google Scholar 

  • Lê AD, Wang A, Harding S, Juzytsch W, Shaham Y (2003) Nicotine increases alcohol self-administration and reinstates alcohol seeking in rats. Psychopharmacology 168:216–221

    Article  PubMed  CAS  Google Scholar 

  • Madden PA, Heath AC, Starmer GA, Whitfield JB, Martin NG (1995) Alcohol sensitivity and smoking history in men and women. Alcohol Clin Exp Res 19:1111–1120

    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. Alcohol Clin Exp Res 17:140–146

    Article  PubMed  CAS  Google Scholar 

  • McKee SA, Krishnan-Sarin K, Shi J, Mase T, O’Malley SS (2006) Modeling the effect of alcohol on smoking lapse behavior. Psychopharmacology 189:201–210

    Article  PubMed  CAS  Google Scholar 

  • Mello NK, Mendelson JH, Sellers ML, Kuehnle JC (1980) Effect of alcohol and marijuana on tobacco smoking. Clin Pharmacol Ther 27:202–209

    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 

  • Michel C, Battig K (1989) Separate and combined physiological effects of cigarette smoking and alcohol consumption. Psychopharmacology 97:65–73

    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 

  • Mintz J, Phipps C, Arruda MJ, Glynn SM, Schneider NG et al (1991) Combined use of alcohol and nicotine gum. Addict Behav 16:1–10

    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 

  • Nadel R, Chappell AM, Samson HH (1998) Effects of nicotine and mecamylamine microinjections into the nucleus accumbens on ethanol and sucrose self-administration. Alcohol Exp Clin Res 22:1190–1198

    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 

  • Palfai TP, Monti PM, Ostafin B, Hutchison K (2000) Effects of nicotine deprivation on alcohol-related information processing and drinking behavior. J Abnorm Psychology 109:96–105

    Article  CAS  Google Scholar 

  • Perkins KH, Sexton JE, Dimarco A, Grobe J, Scierka A, Stiller RL (1995) Subjective and cardiovascular responses to nicotine combined with alcohol in male and female smokers. Psychopharmacology 119:205–212

    Article  PubMed  CAS  Google Scholar 

  • Perkins KA, Fonte C, Grobe JE (2000a) Sex differences in the acute effects of cigarette smoking on the reinforcing value of alcohol. Behav Pharmacol 11:63–70

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  • Pickworth WB, Fant RV, Butschky MF, Henningfield JE (1996) Effects of transdermal nicotine delivery on measures of acute nicotine withdrawal. J Pharmacol Exp Ther 279:450–456

    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 

  • 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 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 

  • Smith BR, Horan JT, Gaskin S, Amit Z (1999) Exposure to nicotine enhances acquisition of ethanol drinking by laboratory rats in a limited access paradigm. Psychopharmacology 142:408–412

    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: JB Fertig, JP Allen (eds) Alcohol and tobacco: from basic science to clinical practice. National Institutes of Health, Bethesda, MD, pp 207–224

    Google Scholar 

  • Soderpalm B, Reicson M, Olausson P, Blomqvist O, Engel JA (2000) Nicotine mechanisms involved in dopaminergic activating and reinforcing properties of ethanol. Behav Brain Res 113:85–96

    Article  PubMed  CAS  Google Scholar 

  • Tiffany ST, Cox LS, Elash CA (2000) Effects of transdermal nicotine patches on abstinence-induced and cue-elicited craving in cigarette smokers. J Consult Clin Psychol 68:233–240

    Article  PubMed  CAS  Google Scholar 

  • Vaillant GE, Schnurr PP, Baron JA, et al (1991) A prospective study of the effects of cigarette smoking and alcohol abuse on mortality. J Gen Intern Med 6:299–304

    Article  PubMed  CAS  Google Scholar 

  • Vuchinich RE, Tucker JA (1988) Contributions from behavioral theories of choice to an analysis of alcohol use. J Abnorm Psychology 97:181–195

    Article  CAS  Google Scholar 

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

    Google Scholar 

  • Young EM, Mahler S, Chi H, de Wit (2005) Mecamylamine and ethanol preference in healthy volunteers. Alcohol Clin Exp Res 29:58–65

    Article  PubMed  CAS  Google Scholar 

  • Zevin S, Jacob P, Benowitz NL (1998) Dose-related cardiovascular and endocrine effects of transdermal nicotine. Clin Pharmacol Ther 64:87–95

    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 

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Acknowledgments

We would like to thank Dr. Peter Jatlow, PI of the Laboratory Core (P50AA015632) for analyzing the nicotine plasma samples. GlaxoSmithKline generously provided the active and placebo transdermal nicotine replacement patches.

Funding: R03AA013622; R01AA015596; P50DA13334, P50AA015632, K05AA014715, CTSA-UL1RR024139.

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Authors and Affiliations

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

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

  2. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Julia Shi

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  1. Sherry A. McKee
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  2. Stephanie S. O’Malley
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  3. Julia Shi
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Correspondence to Sherry A. McKee.

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McKee, S.A., O’Malley, S.S., Shi, J. et al. Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration. Psychopharmacology 196, 189–200 (2008). https://doi.org/10.1007/s00213-007-0952-3

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