Nicotine metabolism linked with chronic alcohol abuse may contribute to poor smoking cessation rates

For smokers who are addicted to alcohol, chronic alcohol abuse may increase the rate of nicotine metabolism and contribute to poor smoking cessation rates. When smokers stop drinking the nicotine metabolism rates decline significantly, according to a study conducted by an international research team led by Roswell Park Cancer Institute (RPCI). The research was a collaboration of scientists from Roswell Park, the University of California, San Francisco, and the Medical University of Silesia and Center of Addiction Treatment in Poland.

The information, published in the journal Drug and Alcohol Dependence, may inform future smoking cessation interventions among heavy alcohol users.

"Our study showed that chronic heavy alcohol consumption may lead to an increase in the rate of nicotine metabolism, which could be one contributing factor to the poor smoking cessation rates in smokers addicted to alcohol," says senior author, Maciej Goniewicz, PhD, PharmD, Assistant Professor of Oncology in the Department of Health Behavior at Roswell Park. "It is an important finding since a faster rate of nicotine metabolism was previously found to be associated with smoking more cigarettes per day, greater nicotine withdrawal symptoms and decreased efficacy of nicotine replacement therapy for smoking cessation. Importantly, we also found that when smokers stopped drinking, their nicotine metabolism slowed down."

The study was conducted from September 2011 to May 2012 at the Center for Addiction Treatment, an inpatient program providing treatment for alcohol dependence in Parzymiechy, Poland. A total of 318 participants were screened for eligibility, and 270 consented to participate in the study. Nicotine biomarkers were assessed in 22 participants selected randomly among male smokers from that group. The data collection occurred after cessation of alcohol consumption at three time points: baseline, week four and week seven. The results suggest that a normalization of nicotine metabolism occurred by week four of abstinence from alcohol.

"Understanding changes in nicotine metabolism associated with chronic alcohol abuse and recovery during alcohol abstinence could have important implications for understanding smoking behavior and improving smoking cessation interventions for current and former heavy alcohol drinkers," adds paper co-author Neal Benowitz, MD, Professor of Medicine at the University of California, San Francisco. "This could have implications for the timing or choice of smoking cessation treatments in recovering alcoholics."