4 Key Facts about Smoking and Alcohol

4 Key Facts about Smoking and Alcohol

Many of us are used to seeing smoking and alcohol literally go hand-in-hand. On the patios at bars, at music festivals, and in movies when someone is feeling stressed or down.

But smoking and alcohol are a dangerous combination, and not just because of the increased health risks. Called “poly-use,” the interplay between nicotine and alcohol can have a major effect on an individual’s ability to quit either substance and stay quit.

Consider these 4 key facts about smoking and alcohol

Nicotine and alcohol can trigger the desire to use the other.

A trigger is something that reminds your brain to do something. For example, if someone is used to smoking cigarettes while drinking alcohol, their brain may connect the two so that whenever they drink, their brain expects to smoke, also. These are called conditioned responses.

Among patients who smoke and drink alcohol, the site of an ashtray increases alcohol craving and the smell of alcohol increases craving to smoke (cross cue-reactivity). Experiencing triggers makes it harder to stay quit.

Nicotine can increase tolerance to alcohol.

When someone develops a tolerance to nicotine, it can impact their tolerance to alcohol and vice versa. This means someone needs more of that substance to get the same pleasurable effects from it, and the higher one’s tolerance is, the harder it can be to stop using that substance.

Drinking alcohol lowers inhibitions.

Inhibition helps you control your decisions. When people drink alcohol, they tend to make different choices than they would have made while sober (such as not smoking). Alcohol has been shown to decrease the time to starting to smoke, which makes it difficult for patients who are trying to quit smoking stay quit.

Smoking can make sobriety harder.

Smokers with a history of problem drinking who continue smoking are at a greater risk of relapsing with alcohol compared to adults who do not smoke.

However, there are ways to make quitting tobacco easier for those who drink, opening opportunities for them to live free from other addictions, too.

Tactics to make quitting easier

Proven approaches used by the EX Program can make quitting tobacco easier if participants drink. These approaches include:

  • Medication. Nicotine interacts with the chemicals in alcohol to make smoking feel more rewarding to the brain. This interaction makes it even harder to resist the urge to smoke.

Nicotine replacement therapy (NRT), like nicotine gum, patches, or lozenges, makes nicotine cravings and withdrawal less intense. Plus, using NRT can double an individual’s chances of staying quit.

  • Behavioral strategies. Over time, smoking while drinking becomes a learned behavior. The good news is that this behavior can be unlearned. The key is to learn new ways to address the triggers and cravings that don’t involve using nicotine.

EX Program’s highly experienced EX Coaches do this type of work every day, helping people manage cravings and stress without tobacco. Our coaches connect with participants to help them build the skills and strategies to address the behavioral, physical, and social aspects of nicotine addiction.

  • Support system. Having a support system that understands the struggles of addiction can make quitting easier. People who have positive support are also more successful in staying quit.

In addition to coaches who provide support, the EX Program includes access to the longest running online community of thousands of current and former tobacco users, many of whom also share their experiences navigating alcohol in their quit journey.

Here, members share unrivaled peer social support, candid advice, and powerful motivation. Plus, research shows that participating in our online community is a key driver of quitting success.

The EX Program is a strong partner to help individuals on the path to living free from nicotine addiction no matter what their situation. We believe everyone can quit for good with the right skills and confidence to make it stick.

To learn more about how the EX Program, developed with Mayo Clinic,  works to support individuals to live tobacco free, please visit the Program page.

To see examples of Truth Initiative research on tobacco cessation interventions for those with poly substance use, visit:

Jon Ebbert MD

Jon O. Ebbert, MD, Medical Director, Nicotine Dependence Center, Mayo Clinic

Dr. Jon O. Ebbert is a Professor of Medicine, Medical Director for the Nicotine Dependence Center, Associate Chair for the Department of Medicine for Innovation, and a general internist with an active telehealth practice focused on rural healthcare for patients with medically-complex illnesses. He has worked in cancer control for over 25 years with 150 publications focused on tobacco dependence treatment.

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