Effect of cigarette smoking on ACTH/cortisol secretion in alcoholics aftershort- and medium-term abstinence

Background: To gain a better insight into the alterations of the hypothalam ic-pituitary-adrenal axis in alcoholism, we evaluated the ACTH response to nicotine inhaled from cigarette smoking (two nonfilter cigarettes in succes sion within 10 min) in nine nonalcoholic men and nine age- and weight-match ed alcoholic men who had been addicted to alcohol for at least 8 years. All subjects were regular cigarette smokers. Methods: Alcoholic men were tested after 2 weeks of abstinence, when the po ssible interferences because of alcohol assumption or the acute withdrawal period had completely ceased, and again after 12 weeks of abstinence. Results: At both 2 and 12 weeks of abstinence, basal plasma ACTH and cortis ol levels were not significantly different in the alcoholic men from those observed in the control group. In the control group subjects, cigarette smo king induced a striking increase in the circulating concentrations of ACTH and cortisol, with peak responses 1.4 and 1.5 times higher than baseline at 20 and 30 min, respectively In contrast, no significant ACTH/cortisol incr ease was observed in alcoholic subjects at any time after cigarette smoking in any test. Conclusion: These data suggest that alterations of nicotinic cholinergic tr ansmission occur in the control of ACTH secretion in the alcholic men, prov iding further evidence of modification of the hypothalamic-pituitary-adrena l axis in alcoholism.