Influences of Barriers to Cessation and Reasons for Quitting on Substance Use among Treatment-Seeking Smokers Who Report Heavy Drinking

Influences of barriers to cessation and reasons for quitting on substance use among treatment-seeking smokers who report heavy drinking. Strong associations between tobacco and alcohol use have been documented. Roughly 85% of smokers drink alcohol, and drinkers are 75% more likely to smoke relative to those who abstain from alcohol. Smokers with alcohol problems (relative to smokers without alcohol problems) tend to also report lower tobacco quit rates, be more dependent on nicotine, and die at higher rates from diseases linked with smoking as opposed to alcohol causes. Concurrent use has reciprocal effects such that use of one substance predicts use of the other, and concurrent use also has multiplicative effects greater than the independent risk of either substance.

Multiple perspectives have emerged with respect to treatment for co-use. One perspective suggests that coping with withdrawal symptoms following treatment for concurrent alcohol and tobacco use may be a barrier to successful cessation . Another perspective suggests one drug may become a conditioned stimulus for the other; and thus, concurrent treatment may improve abstinence rates relative to treating each substance separately. Research has explored efficacy of concurrent treatment , and findings largely support targeting cooccurring substance use. However, further work is needed to understand effects of behaviorally- and cognitively-based quit processes on concurrent substance use. Examination of quit processes among smokers who drink heavily is important in elucidating the extent to which changes in behavioral (the use of quit methods) and cognitive (e.g., quit barriers, reasons for quitting) variables are linked with use, and whether these processes uniquely or differentially influence substance use outcomes.