Many Recovering Alcoholics Depend on Coffee, Cigarettes

But smoking may increase the likelihood of relapse, expert says

FRIDAY, July 18, 2008 (HealthDay News) -- Of the more than 1 million Americans who join Alcoholics Anonymous (AA), almost all drink coffee and close to 60 percent smoke, Vanderbilt University researchers report.

Most recovering alcoholics drink coffee for its stimulatory effects, and smoking reduces feelings of depression, anxiety and irritability, the researchers noted.

"Normally, coffee drinking and cigarette smoking go together," said lead researcher Dr. Peter R. Martin, director of the Vanderbilt Addiction Center. "But recovering alcoholics tend to smoke less than drink coffee."

About 90 percent drink coffee, but only about 60 percent smoke cigarettes, Martin said. "That's interesting disassociation between the two behaviors," he said.

The report is published in the October issue of Alcoholism: Clinical and Experimental Research.

In the study, Martin's team asked 289 AA members about their coffee and cigarette and alcohol consumption.

Of the 88.5 percent who drank coffee, 33 percent drank more than four cups a day. Most reported drinking coffee did make them feel better and helped them concentrate and be more alert.

Of the AA members, 56.9 percent smoked. Among smokers, 78.7 percent smoked at least half a pack a day and more than 60 percent considered themselves highly dependent on cigarettes.

The benefits of smoking were the reduction of negative feelings, including depression and anxiety and irritability. These feelings were likely to contribute to new bouts of drinking, Martin said.

The remaining question is whether drinking coffee and smoking cigarettes plays a role in recovering from alcoholism, Martin said. "Is there something in coffee that may be protective against relapse? Is there something in cigarettes that may actually reduce the likelihood of relapse?" he asked.

Selena Bartlett, the Sidney R. Baer Jr. Foundation Investigator at the Ernest Gallo Clinic and Research Center of the University of California, San Francisco, thinks that the reliance on cigarettes by most recovering alcoholics has a biological basis and may actually increase the chances of relapse.

"This finding supports the potential role that nicotine can play in alcohol addiction," Bartlett said.

In animal experiments, Bartlett found that nicotine can cause relapses to alcohol drinking. "But we don't know how nicotine and alcohol react to keep each other going," she said.

Nicotine has its own specific system in the brain, and alcohol may interact with that system, Bartlett said. Recovering alcoholics who continue to smoke may be more likely to relapse than nonsmokers, she added.

"My prediction would be that the relapse rate among smokers is higher," Bartlett said.

Bartlett thinks that nicotine addiction and alcohol addiction need to be treated together. To that end, she is involved in the study using the smoking cessation drug Chantix to see if both alcohol and nicotine addiction can be treated with this single medication.

"The drug inhibits the effect of nicotine, and by doing that, you may also reduce the euphoric effects of alcohol at the same time," Bartlett said. "We already have some evidence that it may work."

More information

For more about alcoholism, visit the U.S. National Institute on Alcohol Abuse and Alcoholism.

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