The relationship between alcohol use and cigarette smoking in a sample of undergraduate college students

During the decade of the 1990s, smoking prevalence increased nearly 30% in the college student population. Although most college students initiate smoking before the age of 18, recent evidence suggests a sizable minority of undergraduates report starting smoking while in college. This study examined the concurrent use of alcohol and tobacco as well as the relationship between alcohol use and smoking initiation among a sample of undergraduate students attending a large public university in the southwestern United States. We defined three categories of smoking status for this study: never smokers (n=777), experimenters (n=158), and smokers (n=178). Both experimenters and smokers reported consuming significantly more drinks per occasion in the past 28 days and more drinks on one occasion in the past 2 weeks compared to never smokers; however, there was no significant difference between experimenters and smokers on either of these measures of consumption. The results of two multinomial logistic regression models showed that measures of alcohol consumption and drinking frequency were significantly associated with being an experimenter or smoker after controlling for demographic and other drug use covariates. Results of a logistic regression analysis revealed a significant relationship between past year drinking frequency and smoking initiation among respondents who reported that they were not smoking at all 12 months prior to their survey participation. The influence of alcohol consumption on smoking initiation among college students is discussed.     

Internet-based group contingency management to promote abstinence from cigarette smoking: a feasibility study

Background

In contingency management (CM) interventions, monetary consequences are contingent on evidence of drug abstinence. Typically, these consequences are contingent on individual performance. Consequences contingent on group performance may promote social support (e.g., praise).

Methods

Thus, to combine social support with the monetary incentives of CM, we integrated independent and interdependent group contingencies of reinforcement into an Internet-based intervention to promote smoking abstinence. Breath carbon monoxide (CO) measures were compared between treatment conditions and a baseline control condition. Thirteen participants were divided into 5 groups or “teams” (n = 2-3 per team). Each participant submitted video recordings of CO measurement twice daily via the Internet. Teammates could monitor each other's progress and communicate with one another through an online peer support forum. During a 4-day tapering condition, vouchers exchangeable for goods were contingent on gradual reductions in breath CO. During a 10-day abstinence induction condition, vouchers were contingent on abstinence (CO ≤ 4 ppm). In both treatment conditions, concurrent independent and interdependent group contingencies were arranged (i.e., a mixed contingency arrangement).

Results

Less than 1% of CO samples submitted during baseline were ≤ 4 ppm, compared to 57% submitted during abstinence induction. Sixty-five percent of participants’ comments on the online peer support forum were rated as positive by independent observers. Participants rated the intervention favorably on a treatment acceptability questionnaire.

Conclusion

The results suggest that the intervention is feasible and acceptable for promoting abstinence from cigarette smoking.     

A brief 7-day estimate of alcohol consumption for use in smoking cessation clinical trials

Accruing evidence of an association between drinking and smoking relapse suggests that it is important to measure alcohol use in smoking cessation studies. However, most studies do not do so, often because of the extra time burden required for these assessments. Data from participants (N = 634) in two smoking cessation clinical trials were used to examine the relationship between short and longer periods of monitoring for a number of Timeline Followback (TLFB) drinking metrics at baseline and during treatment. High intercorrelations were found between short (7 and 14 days) and longer (30 and 60 days) time windows for baseline drinking data. Intercorrelations between short (last 7 days of treatment) and longer (entire treatment period) time windows of drinking data during the smoking cessation treatment period were also mostly in the high range. Although total abstinence was significantly overestimated with shorter time windows, for those who were misclassified, percentage of days abstinent was high and percentage of heavy drinking days and number of drinks per drinking day were low during the longer period. Thus, a brief estimate of alcohol use over 7 days at baseline is likely to provide a representative assessment of percentage of days abstinent, percentage of heavy drinking days, and number of drinks per drinking day. To estimate abstinence at baseline and during treatment, however, a more comprehensive period of monitoring may be required.     

The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents'' motivations for alcohol, cigarette, and marijuana use

The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age = 15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted "risky" substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety-coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.     

Youth crowds and cigarette smoking: A prospective study

This study examined the prospective relationship between crowd affiliation and smoking behavior among a national sample of 16–22 year old Danes (N = 952). Self-reported data were collected by means of a postal questionnaire at baseline and at 18 months follow-up. The sample included participants, who at baseline reported to identify with a crowd with either a low-smoking norm (n = 705) or a high-smoking norm (n = 247). The results showed that participants, who at baseline identified with a crowd with a high-smoking norm were compared to those, who identified with a low-smoking norm crowd, more likely to have started smoking at time of the follow-up (OR = 2.15). Further, discordance between one's behavior and the norm of the crowd resulted more often in a change in smoking behavior (OR = 2.00) and crowd identification (OR = 2.15) than the absence of such discordance. The results confirm the importance of crowds in smoking initiation and call for more attention to this issue in smoking prevention.     

Family income trajectory during childhood is associated with adolescent cigarette smoking and alcohol use

Background

Although childhood socioeconomic disadvantage has been linked with adolescent tobacco and alcohol use in cross-sectional research, less is known about the influence of changes in socioeconomic status during childhood. Upward socioeconomic mobility may attenuate the negative influence of earlier socioeconomic disadvantage on health, while downward mobility may counter the health benefits of earlier socioeconomic advantage. This study evaluated the influence of common trajectories of family income during childhood on smoking and alcohol use during adolescence.

Methods

Data utilized were part of the 15-year longitudinal Study of Early Child Care and Youth Development. A 5-class trajectory model (two stable, one downward, and two upward income trajectories) was developed previously with this sample (N = 1356). Logistic regression analyses were conducted to determine whether children of the more disadvantaged income trajectories were more likely to engage in tobacco and alcohol use at age 15 relative to those of the most advantaged trajectory.

Results

Family income trajectory was significantly associated with ever-smoking (p = .02) and past-year alcohol use at age 15 years (p = .008). Children from the less advantaged trajectories were more likely to have ever-smoked than children of the most advantaged trajectory (all p's < .05). Children of the downwardly mobile trajectory were more likely to have used alcohol within the past year than children of the most advantaged trajectories as well as the most disadvantaged trajectory (all p's < .05).

Conclusions

Findings indicate that childhood socioeconomic disadvantage influences adolescent smoking, while downward socioeconomic mobility influences adolescent alcohol use.     

Reciprocal effects of alcohol and nicotine in smoking cessation treatment studies

Objective

Smoking and alcohol use are highly related; as such the present study investigated whether alcohol use is associated with failure in tobacco cessation attempts. We first examined the self-reported drinking behavior and smoking over the course of a year at a basic level. Next, we addressed two hypotheses to characterize this relationship at a deeper level: (Hypothesis 1) Alcohol use would be lower for those who attempted to quit smoking (quit for one or more days) during the year compared to those who never quit, and (Hypothesis 2) for those who relapsed to smoking after a quit increases in alcohol consumption would be positively associated with increases in smoking.

Method

Subjects were participants in two smoking cessation programs. One group of participants (N = 139) was part of a smoking cessation study in alcohol dependent smokers in early recovery and the other group of participants (N = 163) was drawn from a smoking cessation study for HIV positive smokers.H1 was tested using t-tests. For H2, a time series analysis examined relationships between smoking and alcohol use within person over a one year period. For H1 and for H2, the analyses utilized bivariate time series procedures. Timeline follow-back data allowed for detailed daily reports of both tobacco and alcohol use.

Results

In the overall sample, there was no difference in alcohol use between those who stopped smoking and those who never stopped. However, when broken up by study, a difference was found in the alcohol dependent sample such that mean drinks were higher for those who stopped compared to those who never stopped smoking (H1). The results indicated a high number of positive significant cross-correlations between tobacco and alcohol use such that one substance predicted current, as well as past and future use of the alternate substance. Same-day cross-correlations were the most common, and dissipated with time (H2).

Conclusions

This analysis provided insights into the proximal influence of one substance on the other. Alcohol is related to relapse in smoking cessation attempts. It is important that smoking cessation efforts in alcohol using populations consider alcohol use in treatment.     

Adolescent nicotine dependence symptom profiles and risk for future daily smoking

Recent research on adolescent smokers suggests that there are important differences in the types of nicotine dependence (ND) symptoms that emerge and different patterns of ND symptoms. The purpose of this study was to use data from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study to identify latent subgroups of adolescent experimental and nondaily smokers varying in number and types of endorsed ND symptoms. Profiles were identified using baseline level of smoking, individual patterns of ND symptoms and other ND risk factors. Discrete time survival analysis was used to examine profile differences in probability of becoming daily smokers 48 months later. Four distinct subgroups of smokers with different patterns of smoking behavior, ND symptoms, and alcohol and other substance use emerged. Heavier smoking adolescents with high symptom endorsement, particularly the need to smoke in the morning, were most likely to become daily smokers 48 months later. A subgroup of social smokers had high smoking exposure and symptom endorsement (except need to smoke in the morning), and high levels of other substance use. Despite lower rates of smoking frequency and quantity compared to the heavier smoking class, 36% of these adolescents smoked daily by 48 months, with a steeper decline in survival rates compared to other lighter smoking classes. Morning smoking symptoms and symptoms prioritizing smoking (i.e., choosing to spend money on cigarettes instead of lunch or smoking when ill or where smoking is forbidden) might quickly identify adolescent non-daily smokers with more severe dependence and higher risk for daily smoking. A focus on skills for avoiding social situations involving use of alcohol and other drugs and reducing peer smoking influences may be an important focus for reducing smoking and other substance use among social smokers.     

Experimenting and daily smokers: Episodic patterns of alcohol and cigarette use

Alcohol use may facilitate the development of nicotine dependence. Alcohol is often paired with cigarette smoking, particularly in those experimenting with smoking. However, little research has examined episodic patterns of alcohol and cigarette use. This study examined patterns of alcohol and cigarette use in a college-aged sample (n = 237) designated as experimenters or smokers based on their smoking history. Participants reported their consumption of drinks and cigarettes by hour, for each hour, of a typical drinking and smoking episode. Self-reported pleasure and desire associated with smoking generally and while drinking was assessed. No group difference was observed in total number of drinks. However, experimenters delayed smoking until more drinks were consumed, suggesting they smoked after reaching binge levels of alcohol. By contrast, smokers smoked after fewer drinks. Both groups reported increased smoking while drinking and increased pleasure and desire when smoking while drinking. The increase was greater in experimenters. Concurrent alcohol and cigarette use may facilitate the development of tobacco dependence and interventions interrupting their pairing might impede the transition from experimenter to smoker.     

Parental prompts as risk factors for adolescent trial smoking: results of a prospective cohort study

Our earlier cross-sectional research suggested that smoking parents, particularly Latino parents, engage in behaviors that may prompt their children to smoke (e.g., request their child to start the parent's cigarette in his/her own mouth). This prospective study of 478 adolescent never-smokers, mostly Latino, suggests that parental prompts to smoke were not significantly related to smoking initiation among adolescents over a 1-year period.     

Young adult non-daily smokers: patterns of alcohol and cigarette use

Binge drinking and non-daily cigarette smoking are behaviors that are both problematic and prevalent in young adults. Although the relationship between drinking and daily smoking has been well categorized, the intersection between drinking and smoking in non-daily smokers has not been heavily researched. Past 30-day and within-episode patterns of alcohol and cigarette use were collected in young adult non-daily smokers (N=40). Results demonstrated that 79% of smoking occurred on drinking days. Alcohol use was significantly greater on smoking days with the result that drinking to risky binge levels was more likely to occur on a smoking day. Smoking typically occurred after a certain level of alcohol pre-load (2.87 drinks). Together these results confirm that young adult non-daily smokers often concurrently use alcohol and cigarettes. Research is needed to identify possible mechanisms underlying the association between binge drinking and cigarette use in this vulnerable population.     

Separate and combined psychophysiological effects of cigarette smoking and alcohol consumption

The present study on the separate and the combined effects of cigarette smoking and alcohol consumption on behavioral, electrocortical and cardiovascular functions involved 20 young female smokers, repeatedly tested on their performance in a visual information processing task before and after drug treatment. Each subject participated in four sessions where they received in a balanced sequence 0.7 g/kg alcohol or placebo followed by either real or sham smoking of a cigarette. The mental task required the subjects to detect sequences of three odd or even digits in a pseudorandom series of single digits presented on a TV screen. By using a variable subject-paced interstimulus interval, mental performance was analyzed continuously in terms of the achieved processing rate. The multivariate assessment of psychophysiological functions included the electrocardiogram, the finger plethysmogram and the electroencephalogram (EEG) measured on four electrode locations (Fz, Cz, P3, P4). The EEG was analyzed both for tonical changes in frequency distribution and for phasic responses to the correctly detected triads (Event-Related Potentials, ERP), yielding a CNV after the second digit and a late positive wave (LP) after the third digit. Cigarette smoking increased the processing rate, while it was decreased by alcohol. Smoking after alcohol diminished the performance decline due to alcohol. Heart rate acceleration and peripheral vasoconstriction were observed after smoking. Alcohol caused dilatation of the finger vessels which was prevented by smoking a cigarette after the drink. Electrocortically, smoking caused an increase in power and maximal frequency within the beta range of the tonic EEG while the ERP analysis revealed topographical changes in N1 and LP and a reduction of the CNV. These effects, which were not observed when drinking alcohol before smoking, suggest a relation of these changes to the increased stimulus processing ability. Alcohol on the other hand caused an increase in alpha power and a decrease in the LP magnitude, which might reflect the deteriorated cognitive performance after this drug.     

Adolescent personality profiles, neighborhood income, and young adult alcohol use: a longitudinal study

Personality traits and socioeconomic factors such as neighborhood income have been identified as risk factors for future alcohol abuse, but findings have been inconsistent possibly due to interactions between risk and protective factors. The present study examined the prediction of drinking behavior using empirically derived multi-trait patterns and tested for moderation by average neighborhood income. Using latent profile analysis (LPA) in a sample of 863 Dutch adolescents, four empirical personality profiles based on 6 traits were observed: Extraverted, Dysregulated, Neurotic, and Regulated. Dysregulated and Extraverted youth drank higher quantities of alcohol more frequently in young adulthood relative to the Regulated group, above and beyond the effects of baseline adolescent drinking, age, and sex. Profile levels of neuroticism did not appear to affect drinking behavior. Average neighborhood income did not moderate adolescent personality and young adult drinking. These findings suggest that future alcohol research should consider individual trait patterns to inform prevention and intervention efforts, and theories implicating both positive and negative emotionality traits as risk factors for drinking are preferable to those emphasizing the importance of the latter.     

Incapacitated rape and alcohol use: a prospective analysis

This study examined timing of alcohol-related sexual assaults (incapacitated rape) in relation to both alcohol consumption and alcohol-related negative consequences. The sample was drawn from a randomly selected pool of college students across three campuses (n=1238) followed over a three year time period. 91% of students never experienced an incapacitated rape, 2% reported an incapacitated rape prior to the first assessment point (n=30), and 6% reported one over the course of the study (n=76). Results indicated that incapacitated rape was associated with higher alcohol use and more negative consequences in the years prior to the assault. Incapacitated rape was also associated with higher alcohol use and more negative consequences during the year in which the rape took place and subsequent years, with highest rates measured for the year of the rape. These results suggest alcohol use can function as both risk factor and consequence of sexual victimization.     

Symptoms of alcohol dependence and smoking initiation and persistence: A longitudinal study among US adults

Background

A large number of adults report symptoms of, but do not meet diagnostic criteria for, an alcohol use disorder. Yet, little is known about the relationship between symptoms of alcohol use disorders and the initiation and persistence of smoking. This study prospectively examines the relationship between having 1–2 symptoms of alcohol dependence (without abuse) and smoking initiation and persistence as well as nicotine dependence over a 3-year period among adults in the United States.

Methods

Data were drawn from Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Relationships between Wave 1 symptoms of alcohol dependence, alcohol abuse, and alcohol dependence and initiation and persistence of cigarette smoking and nicotine dependence at Wave 2 were examined using logistic regression analyses. Analyses were adjusted for demographics, mood and anxiety disorders.

Results

Symptoms of alcohol dependence were associated with smoking initiation at Wave 2. There was no association between symptoms of alcohol dependence and smoking persistence. Symptoms of alcohol dependence predicted incident and persistent nicotine dependence. Findings persisted after adjusting for demographic characteristics and mood/anxiety disorders.

Conclusions

Even 1–2 symptoms of alcohol dependence are associated with increased vulnerability to smoking initiation and onset and persistence of nicotine dependence at a similar strength as alcohol use disorders. Efforts at smoking cessation must address problematic alcohol use, even at the subclinical level, in order to improve efficacy.     

Some correlates between cigarette smoking and alcohol use.

Based on parallels that have been noted between cigarette smoking and alcohol use, recent advances in alcoholism treatment strategies are extrapolated to cigarette smoking treatment. These include: training individuals in self-control strategies, particularly training to deal with stressful situations in alternative ways; continued exploration of the possibility of controlled smoking treatments and determination of the type(s) of individual(s) best suited to such a treatment goal; and, examining variables other than simple abstinence to determine treatment effectiveness.     

Perceived parental reactions and peer respect as predictors of adolescent cigarette smoking and alcohol use

Cigarette smoking and alcohol use contribute substantially to the global burden of morbidity and premature mortality. Most use begins during adolescence, often with experimentation taking place between 11 and 15 years of age. This study examined the importance of perceived parental reactions to, and peer respect for, cigarette smoking and alcohol use. Particular attention was given to the relative importance of these variables compared with the more widely examined influences of perceived parental and peer support. Our final models explained 44% of the variance in cigarette smoking and 46% in alcohol use. Most of the explained variance in both cigarette smoking and alcohol use was accounted for by only three variables: peer use, perceived parental reaction to use, and perceived respect from peers if using. Our findings indicate that perceived parental reaction to use and peer respect for use may be important contributors to adolescent cigarette smoking and alcohol use.     

Adolescent tobacco use and substance abuse treatment outcomes

This study investigated the relationship between cigarette-smoking status and 12-month alcohol and marijuana treatment outcomes in a sample of 1,779 adolescents from the Drug Abuse Treatment Outcomes Study for Adolescents. Participants were classified into four groups based on change in cigarette-smoking status from intake to the 12-month follow-up: persistent smokers, nonsmokers, quitters, and smoking initiators. Logistic regression was used to predict likelihood of relapse to alcohol, marijuana, and other drugs after controlling for intake levels and demographic/treatment characteristics. Results found persistent smokers and smoking initiators to have significantly greater odds of alcohol and marijuana relapse compared with quitters. Furthermore, persistent smokers and smoking initiators were also found to have distinctively shorter periods to marijuana relapse at follow-up. Implications for the implementation of tobacco cessation treatment in the context of substance abuse treatment for adolescents are discussed.     

Smoke and mirrors: magnified beliefs that cigarette smoking suppresses weight

Research suggests that for some smokers, weight concerns interfere with smoking cessation. Studies with individuals with eating disorders and weight concerns have indicated that weight-concerned individuals place undue faith in the effectiveness of certain weight control strategies; i.e., adopt a brand of magical thinking pertaining to food rules and dieting behaviors. The current study investigated whether weight-concerned smokers endorsed exaggerated beliefs in the ability of smoking to suppress body weight. Participants were 385 individuals undergoing treatment for smoking cessation. Prior to treatment, participants completed the Smoking Consequences Questionnaire-Adult (SCQ-A), the Dieting and Bingeing Severity Scale, and the Perceived Risks and Benefits Questionnaire (PBRQ). Results indicated that heightened beliefs in the effectiveness of smoking to control weight were related to eating and weight concerns; specifically, strong associations were observed between SCQ-A Weight Control scores and fear of weight gain, loss of control over eating, and body dissatisfaction. Although SCQ-A Weight Control scores were related to (self-reported) weight gain during a previous quit attempt, scores did not predict actual weight gain over the course of the cessation trial. Reported weight gain at previous attempts was also unrelated to actual weight gain over the current trial. These findings indicate that eating and weight-concerned smokers may benefit from psychoeducation concerning the relatively modest and temporary ability of nicotine to suppress weight.