Heavy drinkers who are trying to quit smoking cigarettes may find that cutting back on alcohol can also help them quit their daily smoking habit, according to a new study published in the journal Nicotine & Tobacco Research.

The findings show that as heavy drinkers began drinking less, their nicotine-metabolite ratio — a biomarker that indicates how quickly a person’s body metabolizes nicotine — was also reduced.

Use of both alcohol and cigarettes is widespread, with nearly 1 in 5 adults using both. Cigarette use is especially prevalent in heavy drinkers. Drinking is a well-established risk factor for smoking, and smoking is well-established risk factor for drinking.

Previous studies have shown that people with higher nicotine metabolism ratios are likely to smoke more and have a harder time quitting. Slowing a person’s nicotine metabolism rate by consuming less alcohol could provide an edge when trying to quit smoking, said Sarah Dermody, an assistant professor at Oregon State University (OSU) and the study’s lead author.

“It takes a lot of determination to quit smoking, often several attempts,” Dermody said. “This research suggests that drinking is changing the nicotine metabolism as indexed by the nicotine metabolite ratio, and that daily smoking and heavy drinking may best be treated together.”

Dermody’s research is aimed at better understanding factors that contribute to alcohol and nicotine use and how best to intervene in problematic use of these substances.

For the study, Dermody and colleagues at the Centre for Addiction and Mental Health in Toronto, Canada, wanted to further investigate the links between alcohol and nicotine use. They studied the nicotine metabolite ratio in a group of 22 daily smokers who were seeking treatment for alcohol use disorder for a period of several weeks.

“What’s really interesting is that the nicotine metabolite ratio is clinically useful,” Dermody said. “People with a higher ratio have a harder time quitting smoking cold turkey. They are also less likely to successfully quit using nicotine replacement therapy products.”

The researchers found that as the men in the study group reduced their drinking — from an average of 29 drinks per week to 7 — their nicotine metabolite rate also dropped.

The findings for men replicated those of an earlier study that found similar effects and provide further evidence of the value of the nicotine metabolite ratio biomarker to inform treatment for smokers trying to quit, Dermody said.

“The nicotine metabolite ratio was thought to be a stable index, but it may not be as stable as we thought,” Dermody said. “From a clinical standpoint, that’s a positive thing, because if someone wants to stop smoking, we may want to encourage them to reduce their drinking to encourage their smoking cessation plan.”

Female study participants did not experience reductions in their nicotine metabolite ratio, but the women in the study did not reduce their drinking significantly during the study period.

“The rate of drinking for women in the study started low and stayed low,” Dermody said. “I anticipate that in a larger generalized study we would not see the difference between men and women like that.”

Dermody plans to conduct a new study involving heavy drinkers who also smoke to see if an intervention helps reduce their drinking. The study will also examine the effects on smoking to try and replicate the findings in a larger group.

“This research is demonstrating the value in addressing both smoking and drinking together,” she said. “The question now is how best to do that.”

Source: Oregon State University