Many Recovering Alcoholics
Depend on Coffee, Cigarettes
But smoking may increase the likelihood
of relapse, expert says
By Steven Reinberg
FRIDAY, July 18 (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
"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
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
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
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."
For more about alcoholism, visit the U.S.
National Institute on Alcohol Abuse and Alcoholism.
SOURCES: Peter R. Martin, M.D., professor, psychiatry and
pharmacology, and director, Vanderbilt Addiction Center, Vanderbilt University
School of Medicine, Nashville, Tenn.; Selena Bartlett, Ph.D., director,
Preclinical Development Group NARSAD, Sidney R. Baer Jr. Foundation
Investigator, Ernest Gallo Clinic and Research Center, University of California,
San Francisco; October 2008, Alcoholism: Clinical and Experimental Research
Copyright © 2008 ScoutNews,
LLC. All rights reserved.
Higher Coffee And Cigarette Consumption Among
21 July 21, 2008
More than one million Americans currently participate in the Alcoholics
Anonymous (AA) program. While AA participants are reportedly notorious for their
coffee drinking and cigarette smoking, very little research has quantified their
consumption of these two products. Recent findings confirm that coffee and
cigarette use among this population is greater than among the general U.S.
population: most AA members drink coffee and more than half smoke.
Results will be published in the October issue of Alcoholism: Clinical &
Experimental Research and are currently available at Early View.
"Drinking coffee and smoking cigarettes are part of the culture of AA, but
we knew little about the degree to which this occurred, how much more prevalent
these behaviors were compared to the general American population, or why AA
participants actually drank coffee or smoked cigarettes," said Peter R.
Martin, professor of psychiatry and pharmacology, director of the Vanderbilt
Addiction Center at the Vanderbilt University School of Medicine, and
corresponding author for the study.
Martin added that many questions remain about the effects of coffee and
cigarettes on recovering alcoholics. "What do cigarettes or coffee do for
them; how do they believe that they are affected by smoking and drinking
coffee?," he asked. "Is this behavior simply a way to bond or connect
in AA meetings, analogous to the peace pipe among North American Indians, or do
constituents of these natural compounds result in pharmacological actions that
affect the brain? Perhaps most interesting, how do these consummatory behaviors
affect the brain and what is their role in recovery?"
While the most common cause of death in long-term recovering alcoholics is
related to the health consequences of cigarette smoking, Martin noted, recent
epidemiological studies have shown that coffee consumption is not harmful to
health and may, in fact, reduce the risk of death from suicide, certain cancers,
and other diseases.
While that may be true, noted Robert Swift, professor of psychiatry and human
behavior at Brown University Medical School, little is known about coffee's role
vis-à-vis abstinence, whether drinking coffee makes it easier or harder to stay
sober. "It's possible that coffee is even a gateway drug, with coffee
drinking beginning at about the time persons begin using alcohol. In addition, a
potential negative interaction is coffee's known negative effects on sleep. Many
alcoholics in long-term recovery frequently have trouble with sleep, and coffee
consumption could make sleep problems worse."
A strength of this study, Swift added, is that relatively little is known about
AA, why some persons are helped by it while others are not. "The authors
have been successful in gaining the confidence of AA groups and incorporating
them into a research study," he said.
Martin and his colleagues asked participants (n=289) in all open AA meetings
during the summer of 2007 in Nashville, TN to self-report a variety of
information: a "timeline followback" for coffee, cigarette and alcohol
consumption, the AA Affiliation Scale, coffee consumption and effects questions,
the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects
"The most important finding was that not all recovering alcoholics smoke
cigarettes while almost all drink coffee," said Martin.
More specifically, most individuals (88.5%) consumed coffee and approximately 33
percent drank more than four cups per day. The most common self-reported reasons
were because of coffee's stimulatory effects: feeling better, better
concentration, greater alertness. More than half of the respondents (56.9%)
smoked cigarettes; of those, 78.7 percent smoked at least half a pack per day,
and more than 60 percent were considered highly or very highly dependent. The
most common self-reported reasons were because of smoking's reduction of
"negative affect," which refers to depression, anxiety and
irritability. "Many of these negative affective states are described by
patients as contributors or triggers to relapse after periods of sobriety,"
"I think that it is important for alcohol researchers and clinicians to
know that alcoholics, even those who do not use other illicit drugs, are not
just addicted to alcohol, but use other psychotropic drugs like caffeine and
nicotine," said Swift. "I found it interesting that coffee contains a
lot of psychoactive substances, in addition to caffeine. A second important
aspect is the finding that rates of smoking are much higher in alcoholics in
recovery than in the general population. Smoking kills and is at least as
harmful for alcoholics as is alcohol. Yet, AA tolerates or otherwise does not
address smoking in its members."
"Yet, if coffee is beneficial and cigarettes are harmful to health, AA
members seem to be going in the right direction by reducing smoking and perhaps
increasing their coffee drinking," observed Martin. "We are now
working on more detailed analyses of results to examine whether these changes in
coffee and cigarette use are predictive of recovery from alcoholism per
Article adapted by Medical News Today from original press release.
Alcoholism: Clinical & Experimental Research (ACER) is
the official journal of the Research Society on Alcoholism and the International
Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper,
"Coffee and Cigarette Consumption and Perceived Effects in Recovering
Alcoholics Participating in Alcoholics Anonymous in Nashville, TN," were:
Michael S. Reich and A.J. Reid Finlayson in the Vanderbilt Addiction Center in
the Department of Psychiatry at Vanderbilt University School of Medicine; Mary
S. Dietrich in the Department of Biostatistics at the Vanderbilt University
School of Medicine; and Edward F. Fischer in the Department of Anthropology at
Vanderbilt University. The study was funded by the National Institute on Alcohol
Abuse and Alcoholism, and the National Institute on Drug Abuse.
Source: Peter R. Martin, M.D.
University School of Medicine
Clinical & Experimental Research
Medical News Today: http://www.medicalnewstoday.com
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