ALCOHOL AND SMOKING

It is estimated that 70% of people with alcohol problems are heavy smokers. It is well known that smokers drink and drinkers smoke, but why is this? Why do alcohol and cigarettes go hand in hand?

The precise mechanisms of the alcohol-nicotine relationship are not yet fully understood, but involve complex social and biological and chemical aspects. Alcohol and nicotine both stimulate the release of dopamine and endogenous opioids in the mesolimbic reward pathways of the brain, which give rise to pleasurable and reinforcing affects. Therefore, nicotine increases the urge to drink, or is a cue to drinking, and vice-versa. However, it could be argued that smoking instead would release the same reward chemicals that could satisfy urges for alcohol.

They are also linked in that they are both used within the same social situations and are used in response to stressful situations. Chemically, alcohol is a depressant while nicotine is a stimulant and used together, the two may moderate each other’s effects. Physiologically, the body will metabolise alcohol more quickly if nicotine is present, therefore more alcohol will be needed to reach the desired effect for a smoker.

Risks

We all know that heavy drinking carries with it serious health risks, as does smoking, but put the two together and the risks to health are phenomenal. Heavy drinkers

Dual dependence of alcohol and nicotine bears a shocking 15-fold risk of certain cancers such as brain, mouth, throat, oesophageal, stomach, pancreatic, liver, bowel, bladder, breast and cervical cancers. The reasons for this may be because alcohol interferes with the body’s ability to convert carcinogens into more harmless substances, which it could eliminate more easily. Alcohol may also disrupt the body’s ability to repair DNA that has been damaged by carcinogens, and as we know, tobacco is full of carcinogenic chemicals. On top of this there is a hugely increased risk of liver disease, heart disease, hypertension and sexual dysfunction.

Sexual Dysfunction and Fertility Problems

Alcohol lowers the male hormone testosterone, which causes a reduction in the quantity and quality of sperm. Alcohol and nicotine can both lead to erectile dysfunction in men. Nicotine can also contribute to male infertility as it causes the tails of the sperm to mutate. This means their motility is greatly reduced and they are less likely to reach and fertilise the female egg

Oral Cancers

There are 1500 deaths every year in the UK from oral cancers and 90% of these are the result of excess drinking and smoking. It is a sobering thought that the incidence of oral cancer amongst young women is increasing and it seems no coincidence that the prevalence of heavy drinking and smoking amongst this group is also increasing.

Oesophageal Cancer

Alcohol irritates the lining of the oesophagus. This causes inflammation, which can in turn lead to malignant changes. The risk is greatly increased if an individual also smokes.

Peptic and Duodenal Ulcers

Alcohol irritates and erodes the mucosal lining of the stomach and intestines leading to inflammation and bleeding. Nicotine increases the volume and concentration of gastric acid, which can cause ulcers and slow healing. Together they are a cruel combination.

Treatment

Latest research shows that concurrent treatment of alcohol and tobacco dependence does not seem to cause relapse to drinking, and in fact, may enhance abstinence from drinking. It is therefore important to note that treatment for problem drinkers who smoke should be available whenever and wherever the client comes into contact with the health service.

Professor Robert West, Specialist in Addiction Psychology at the Health Behaviour Unit in London, states that because of the high mortality and morbidity those problem drinkers who smoke experience from tobacco-related diseases, treatment for nicotine addiction is necessary.