Abstract
Rationale
Smoking lapses (i.e., returns to smoking after quitting) often occur following alcohol consumption with observational data suggesting greater quantities of alcohol lead to greater risk. However, a causal dose-dependent effect of alcohol consumption on smoking lapse behavior has not been established, and the mechanisms that might account for such an effect have not been tested.
Objectives
In a within-subjects design, we examined the effects of low- (0.4 g/kg) and high-dose (0.8 g/kg) alcohol, relative to placebo, on smokers’ ability to resist initiating smoking after acute smoking abstinence.
Methods
Participants were 100 heavy alcohol drinkers, smoking 10–30 cigarettes per day. Across three separate days, participants consumed placebo, low-dose, or high-dose alcohol following 3 h of smoking abstinence and, 35 min later, were offered the opportunity to smoke while resisting smoking was monetarily reinforced proportional to the amount of time delayed.
Results
Consistent with a dose–response effect, participants smoked 3.35 min (95 % confidence intervals (CI) [−7.09, 0.40], p = .08) earlier following low-dose alcohol and 6.36 min (95 % CI [−9.99, −2.73], p = .0006) earlier following high-dose alcohol compared to drinking a placebo beverage. Effects of dose on smoking behavior were partially mediated by increases in urge to smoke. There was no evidence that alcohol’s effects on urge to smoke or ability to resist smoking were mediated through its stimulating or sedating effects.
Conclusions
Alcohol can reduce the ability to resist smoking in a dose-dependent fashion, in part, due to its effect on increasing the intensity of smoking urges.
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Acknowledgments
This study was funded by the National Institute on Alcohol Abuse and Alcoholism, grant R01AA016978 to Dr. Kahler, by a Senior Research Career Scientist award from the Department of Veterans Affairs to Dr. Rohsenow, by National Institute on Drug Abuse grant K08-DA025041 to Dr. Leventhal, and by National Institute on Drug Abuse grant K08-DA029094 to Dr. Spillane. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
Conflict of interest
The authors have no financial relationship with the study sponsor, and no conflicts of interest to disclose.
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Kahler, C.W., Metrik, J., Spillane, N.S. et al. Acute effects of low and high dose alcohol on smoking lapse behavior in a laboratory analogue task. Psychopharmacology 231, 4649–4657 (2014). https://doi.org/10.1007/s00213-014-3613-3
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DOI: https://doi.org/10.1007/s00213-014-3613-3