, 207:107 | Cite as

Alcohol-induced increases in smoking behavior for nicotinized and denicotinized cigarettes in men and women

  • Andrea King
  • Patrick McNamara
  • Megan Conrad
  • Dingcai Cao
Original Investigation



Alcohol has been shown to increase smoking urges and smoking behavior. However, alcohol’s effects on specific components of smoking behavior for nicotine versus non-nicotine factors and potential sex differences in this response have not been investigated.


Forty-two young male and female non-dependent, heavy social drinking smokers participated in two double-blind laboratory sessions. They were randomized to either an alcohol (0.8 g/kg; n = 29) or placebo (n = 13) beverage pre-administration group. After beverage consumption, they were assessed for smoking urges and then given the opportunity to smoke cigarettes which were either all nicotinized (0.6 mg/cigarette) or denicotinized (≤0.05 mg/cigarette) over a 3-h period; smoking behavior was quantified by a smoking topography device. Subjects took standardized puffs of the session’s cigarette both before and after beverage administration to provide a reference when making future smoking choices.


Alcohol, compared with placebo beverage, increased both men’s and women’s smoking urge, as well as subjective ratings of smoking reference puffs for either nicotinized or denicotinized cigarettes. In terms of smoking choice behavior, regardless of cigarette type, alcohol (>placebo) increased men’s smoking behavior, including puff count, volume, and duration. In contrast, for women, smoking topography measures did not differ between alcohol and placebo conditions.


In summary regardless of nicotine content, in men, alcohol increased smoking urge and behavior, whereas in women, alcohol increased smoking urge but did not increase smoking behavior. These results indicate that the mechanisms underlying co-use of alcohol and tobacco in women may be more complex than in men.


Alcohol Nicotinized and denicotinized cigarettes Smoking topography Sex differences Non-daily smoker 



This research was supported by NIH/NIAAA (#R03-AA015337, #R01-DA016834), a University of Chicago Cancer Research Center Grant (#P30-CA14599), and a General Clinical Research Center Grant (#M01-RR00055). The authors would like to thank Dr. Royce Lee for performing medical screenings and for medical oversight of the study and Lauren Kemp McNamara for conducting experimental sessions. The experiments in this study comply with the current US laws and were in compliance with the Declaration of Helsinki for human subjects.


  1. Acheson A, Mahler SV, Chi H, de Wit H (2006) Differential effects of nicotine on alcohol consumption in men and women. Psychopharmacology 186:54–63CrossRefPubMedGoogle Scholar
  2. Ait-Daoud N, Wiesbeck GA, Bienkowski P, Li MD, Pfützer RH, Singer MV, Lesch OM, Johnson BA (2005) Comorbid alcohol and nicotine dependence: from the biomolecular basis to clinical consequences. Alcohol Clin Exp Res 29:1541–1549CrossRefPubMedGoogle Scholar
  3. Allen SA, Hatsukami DK, Christianson D, Nelson D (1999) Withdrawal and pre-menstrual symptomatology during the menstrual cycle in short-term smoking abstinence: effects of menstrual cycle on smoking abstinence. Nicotine Tob Res 1:129–142CrossRefPubMedGoogle Scholar
  4. Barrett SP, Tichauer M, Leyton M, Pihl RO (2006) Nicotine increase alcohol self-administration in non-dependent male smokers. Drug Alcohol Depend 81:197–204CrossRefPubMedGoogle Scholar
  5. Benowitz NL, Hatsukami D (1998) Gender differences in the pharmacology of nicotine addiction. Addict Biol 3:383–404CrossRefGoogle Scholar
  6. Bien TH, Burge R (1990) Smoking and drinking: a review of the literature. Int J Addict 25:1429–1454PubMedGoogle Scholar
  7. Bjornson W, Rand C, Connett JE, Lindgren P, Nides M, Pope F, Buist AS, Hoppe-Ryan C, O’Hara P (1995) Gender differences in smoking cessation after 3 years in the lung health study. Am J Public Health 85:223–230CrossRefPubMedGoogle Scholar
  8. Brauer LH, Behm FM, Lane JD, Westman EC, Perkins C, Rose JE (2001) Individual differences in smoking reward from de-nicotinized cigarettes. Nicotine Tob Res 3:101–109CrossRefPubMedGoogle Scholar
  9. Burton SM, Tiffany ST (1997) The effect of alcohol consumption on craving to smoke. Addiction 92:15–26CrossRefPubMedGoogle Scholar
  10. Cohen J (1973) Eta-squared and partial eta-squared in fixed factor ANOVA designs. Educ Psychol Meas 33:107–112CrossRefGoogle Scholar
  11. Conrad MF, McNamara PM, King AC (2009) Effects of blinding procedures on beverage content and subjective alcohol response. Paper presented at the 32nd Annual Conference of the Research Society on Alcoholism, San Diego, CAGoogle Scholar
  12. 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 3:7–16CrossRefPubMedGoogle Scholar
  13. Drobes DJ (2006) Craving reactivity to smoking and alcohol cues in alcoholic and nonalcoholic smokers. Alcohol-nicotine interactions: are women like men? Symposium conducted at the annual meeting of the Society for Research on Nicotine and Tobacco, Orlando, FLGoogle Scholar
  14. Epstein AM, Sher TG, Young MA, King AC (2007) Tobacco chippers show robust increases in smoking urge after alcohol consumption. Psychopharmacology 190:321–329CrossRefPubMedGoogle Scholar
  15. Falk DE, Yi H, Hiller-Sturmhöfel S (2006) An epidemiologic analysis of co-ocurring alcohol and tobacco use disorders. Alcohol Res Health 29:162–171PubMedGoogle Scholar
  16. Field M, Duka T (2004) Cue reactivity in smokers: the effects of perceived cigarette availability and gender. Pharmacol Biochem Behav 78:647–652CrossRefPubMedGoogle Scholar
  17. First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV axis I disorders—patient edition (SCID I/P, Version 2.0). Biometrics Research Department. New York, NYGoogle Scholar
  18. Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS (1990) High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med 322:95–99PubMedGoogle Scholar
  19. FTC (2007) Federal Trade Commission Cigarette Report for 2004 and 2005. Federal Trade Commission, Washington, D.CGoogle Scholar
  20. Glautier S, Clements K, White JAW, Taylor C, Stolerman IP (1996) Alcohol and the reward value of cigarette smoking. Behav Pharmacol 7:144–154CrossRefPubMedGoogle Scholar
  21. Griffiths RR, Bigelow GE, Liebson I (1976) Facilitation of human tobacco self-administration by ethanol: a behavioral analysis. J Exp Anal Behav 25:279–292CrossRefPubMedGoogle Scholar
  22. Hamilton JA, Yonkers KA (1996) Sex differences in pharmacokinetics of psychotropic medications: part I: physiological basis for effects. In: Jensvold M, Halbreich U, Hamilton JA (eds) Psychopharmacology of women: sex, gender, and hormonal considerations. American Psychiatric Press, Washington DC, pp 11–41Google Scholar
  23. Harrison ELR, Desai RA, MccKee SA (2008) Nondaily smoking and alcohol use, hazardous drinking, and alcohol diagnoses among young adults: findings from the NESARC. Alcohol Clin Exp Res 32:2081–2087CrossRefPubMedGoogle Scholar
  24. Harrison ELR, Hinson RE, McKee SA (2009) Experimenting and daily smokers: episodic patterns of alcohol and cigarette use. Addict Behav 34:484–486CrossRefPubMedGoogle Scholar
  25. Henningfield JE, Chait LD, Griffiths RR (1983) Cigarette smoking and subjective response in alcoholics: effects of pentobarbital. Clin Pharmacol Ther 33:806–812PubMedGoogle Scholar
  26. Henningfield JE, Chait LD, Griffiths RR (1984) Effects of ethanol on cigarette smoking by volunteers without histories of alcoholism. Psychopharmacology 82:1–5CrossRefPubMedGoogle Scholar
  27. Istvan J, Matarazzo JD (1984) Tobacco, alcohol, and caffeine use: a review of their interrelationships. Psychol Bull 95:301–326CrossRefPubMedGoogle Scholar
  28. Kalivas PW, Volkow ND (2005) The neural basis of addiction: a pathology of motivation and choice. Am J Psychiatry 162:1403–1413CrossRefPubMedGoogle Scholar
  29. King AC, Epstein AM (2005) Alcohol dose-dependent increases in smoking urge in light smokers. Alcohol Clin Exp Res 29:547–552CrossRefPubMedGoogle Scholar
  30. King AC, Houle T, de Wit H, Holdstock L, Schuster A (2002) Biphasic alcohol response in heavy versus light drinkers. Alcohol Clin Exp Res 26:827–835PubMedGoogle Scholar
  31. King A, Epstein A, Conrad M, McNamara P, Cao D (2008) Sex differences in the relationship between alcohol drinking and smoking behavior: a pilot study. Am J Addict 17:347–353CrossRefPubMedGoogle Scholar
  32. King AC, McNamara P, Cao D (2009) Laboratory and longitudinal examination of co-occurring drinking and smoking behaviors in heavy and light drinkers in their twenties. Poster presented at the 2009 Joint Conference of SRNT and SRNT-Europe, Dublin, IrelandGoogle Scholar
  33. McClernon FJ, Kozink RV, Rose JE (2008) Individual differences in nicotine dependence, withdrawal symptoms, and sex predict transient fMRI-BOLD responses to smoking cues. Neuropsychopharmacology 33:2148–2157CrossRefPubMedGoogle Scholar
  34. Mendelson JH, Goletiani N, Sholar MB, Siegel AJ, Mello NK (2008) Effects of smoking successive low-and high-nicotine cigarettes on hypothalamic-pituitary-adrenal axis hormones and mood in men. Neuropsychopharmacology 33:749–760CrossRefPubMedGoogle Scholar
  35. Mintz J, Boyd G, Rose JE, Charuvastra VC, Jarvik ME (1985) Alcohol increases cigarette smoking: a laboratory demonstration. Addict Behav 10:203–207CrossRefPubMedGoogle Scholar
  36. Perkins KA (1995a) Individual variability in responses to nicotine. Behav Genet 25:119–132CrossRefGoogle Scholar
  37. Perkins KA (1995b) Nicotine discrimination in men and women. Pharmacol Biochem Behav 64:295–299CrossRefGoogle Scholar
  38. Perkins KA (2001) Smoking cessation in women: special considerations. CNS Drugs 15:391–411CrossRefPubMedGoogle Scholar
  39. Perkins KA, Scott J (2008) Sex differences in long-term smoking cessation rates due to nicotine patch. Nicotine Tob Res 10:1245–1251CrossRefPubMedGoogle Scholar
  40. Perkins KA, Grobe JE, Epstein LH, Caggiula A, Stiller RL, Jacob RG (1993) Chronic and acute tolerance to subjective effects of nicotine. Pharmacol Biochem Behav 45:375–381CrossRefPubMedGoogle Scholar
  41. Perkins KA, Sexton JE, Stiller RL, Fonte C, DiMarco A, Goettler J, Scierka A (1994) Subjective and cardiovascular responses to nicotine combined with caffeine during rest and casual activity. Psychopharmacology 113:438–444CrossRefPubMedGoogle Scholar
  42. Perkins KA, Sanders M, D’Amico D, Wilson A (1997) Nicotine discrimination and self-administration as a function of smoking status. Psychopharmacology 131:361–370CrossRefPubMedGoogle Scholar
  43. Perkins K, Donny E, Caggiula AR (1999) Sex difference in nicotine effects and self-administration: review of human and animal evidence. Nicotine Tob Res 1:301–315CrossRefPubMedGoogle Scholar
  44. Perkins KA, Fonte C, Grobe JE (2000) Sex differences in the acute effects of cigarette smoking on the reinforcing value of alcohol. Behav Pharmacol 11:63–70PubMedGoogle Scholar
  45. Perkins KA, Doyle T, Ciccocioppo M, Conklin C, Sayette M, Caggiula A (2006) Sex differences in the influence of nicotine dose instructions on the reinforcing and self-reported rewarding effects of smoking. Psychopharmacology 184:600–607CrossRefPubMedGoogle Scholar
  46. Ray LA, Miranda R, Kahler CW, Leventhal AM, Monti PM, Swift R, Hutchison KE (2007) Pharmacological effects of naltrexone and intravenous alcohol on craving for cigarettes among light smokers: a pilot study. Psychopharmacology 193:449–456CrossRefPubMedGoogle Scholar
  47. Rose JS, Chassin L, Presson CC, Sherman SJ (1996) Demographic factors in adult smoking status: mediating and moderating influences. Psychol Addict Behav 10:28–37CrossRefGoogle Scholar
  48. Rose JE, Behm FM, Westman EC, Johnson M (2000) Dissociating nicotine and nonnicotine components of cigarette smoking. Pharmacol Biochem Behav 67:71–81CrossRefPubMedGoogle Scholar
  49. Rose JE, Brauer LH, Behm FM, Cramblett M, Calkins K, Lawhon D (2004) Psychopharmacological interactions between nicotine and ethanol. Nicotine Tob Res 6:133–144CrossRefPubMedGoogle Scholar
  50. Royce JM, Corbett K, Sorensen G, Ockene J (1997) Gender, social pressure, and smoking cessations: the Community Intervention Trial for Smoking Cessation (COMMIT) at baseline. Soc Sci Med 44:359–370CrossRefPubMedGoogle Scholar
  51. Rukstalis M, Jepson C, Strasser A, Lynch KG, Perkins K, Patterson F, Lerman C (2005) Naltrexone reduces the relative reinforcing value of nicotine in a cigarette smoking choice paradigm. Psychopharmacology 180:41–48CrossRefPubMedGoogle Scholar
  52. SAMHSA (2005) National Survey on Drug Use and Health. Office of Applied Studies, Bethesda, MDGoogle Scholar
  53. Sayette MA, Shiffman S, Tiffany ST, Niaura RS, Martin CS, Shadel WG (2000) The measurement of drug craving. Addiction 95 (Suppl 2):S189–S210Google Scholar
  54. Sayette MA, Martin CS, Wertz JM, Perrott MA, Peters AR (2005) The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers. Psychol Addict Behav 19:263–270CrossRefPubMedGoogle Scholar
  55. Senore C, Battista RN, Shapiro SH, Segnan N, Ponti A, Rosso S, Aimar D (1998) Predictors of smoking cessation following physicians’ counseling. Prev Med 27:412–421CrossRefPubMedGoogle Scholar
  56. Shiffman S (1989) Tobacco “chippers”—individual differences in tobacco dependence. Psychopharmacology 97:539–547CrossRefPubMedGoogle Scholar
  57. Shiffman S, Paty J (2006) Smoking patterns and dependence: contrasting chippers and heavy smokers. J Abnorm Psychology 115:509–523CrossRefGoogle Scholar
  58. Shiffman S, Paty JA, Gnys M, Kassel JD, Elash C (1995) Nicotine withdrawal in chippers and regular smokers: subjective and cognitive effects. Health Psychol 14:301–309CrossRefPubMedGoogle Scholar
  59. Sisson JH (2007) Alcohol and airways function in health and disease. Alcohol 41:293–307CrossRefPubMedGoogle Scholar
  60. Sobell LC, Sobell MB (1995) Alcohol timeline follow-back users’ manual. Addiction Research Foundation, Toronto, CanadaGoogle Scholar
  61. Sobell LC, Maisto SA, Sobell MB, Cooper AM (1979) Reliability of alcohol abusers’ self-reports of drinking behavior. Behav Res Ther 17:157–160CrossRefPubMedGoogle Scholar
  62. Sutker PB, Tabakoff B, Goist KC, Randall CL (1983) Acute alcohol intoxication, mood states and alcohol metabolism in women and men. Pharmacol Biochem Behav 18(suppl):349–354CrossRefPubMedGoogle Scholar
  63. Wetter DW, Kenford SL, Smith SS, Fiore MC, Jorenby DE, Baker TB (1999) Gender differences in smoking cessation. J Consult Clin Psychol 67:555–562CrossRefPubMedGoogle Scholar
  64. Wilson D, Taylor A, Roberts L (1995) Can we target smoking groups more effectively? A study of male and female heavy smokers. Prev Med 24:363–368CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Andrea King
    • 1
    • 3
  • Patrick McNamara
    • 1
  • Megan Conrad
    • 1
  • Dingcai Cao
    • 2
  1. 1.Department of Psychiatry, Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Department of SurgeryUniversity of ChicagoChicagoUSA
  3. 3.Department of Psychiatry and Behavioral NeuroscienceUniversity of ChicagoChicagoUSA

Personalised recommendations