Smoking and drinking among alcoholics in treatment: Cross-sectional and longitudinal relationships

Objective: The relationship between tobacco dependence and alcohol dependen ce has received considerable scrutiny in the past few years. The present st udy of alcoholics in treatment for alcoholism extended previous work by inv estigating the cross-sectional and longitudinal relationships between drink ing and smoking variables. Method: Male and female alcoholics (N = 116) com pleted a standard assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues. Participants' dri nking and smoking were evaluated again 6 months following treatment. Result s: (1) Pretreatment tobacco dependence, pretreatment alcohol dependence, ur ge to smoke and urge to drink were positively correlated; (2) smoking rates and drinking rates were not correlated either before or following treatmen t; (3) pretreatment smoking history did not predict posttreatment drinking; (4) the rate of smoking declined following treatment for alcoholism for 45 % of the smoking patients who completed a 6-month follow-up, independent of relapse status;and (5) relapsers who smoked more heavily also drank less f requently during follow up. Conclusions: Consistent bur modest cross sectio nal relationships between drinking and smoking variables before alcohol tre atment decrease after treatment for alcohol dependence. A spontaneous impro vement in smoking rate occurs in many (45%), particularly among those who s moked more heavily pretreatment and thus benefit most by the reduction. Dir ections for future research are discussed.