Level of Alcohol Consumption and Successful Smoking Cessation.

Introduction: The negative association between heavy alcohol use and likelihood of successful smoking cessation is well established. However, evidence on the effects of moderate alcohol consumption on smoking cessation is sparse. This analysis evaluated the association between alcohol use and smoking and the interaction of alcohol use and use of pharmacotherapy interventions in relation to smoking cessation.

Methods: Data from adults (n=923) recruited through a smoking cessation website between November 2011 and March 2012 were analyzed. Data on past-year alcohol use, tobacco use, and demographics were collected at baseline. Self-reported smoking abstinence and current alcohol use data were collected at 1 and 7 months post-treatment. Chi-square and multivariate logistic regression analyses were conducted.

Results: At 1 month, adjusted odds of continued smoking were 1.54 times greater (95% CI: 1.05, 2.23) for moderate drinkers and 2.59 times greater (95% CI: 1.33, 4.28) for heavy drinkers than non-drinkers. At 7 months, adjusted odds of continued smoking were not greater for moderate drinkers than non-drinkers, and were 2.32 times greater (95% CI: 1.35, 3.96) among heavy alcohol drinkers than non-drinkers. At 1 month, adjusted odds of smoking cessation were 2.33 times greater (95% CI: 1.04, 3.09) for alcohol users assigned to nicotine replacement therapy (NRT) than for those not assigned to NRT. This relationship was not observed at 7 months.

Conclusions: Moderate and heavy drinking might impact smoking cessation efforts. Recent moderate drinking may be associated with short-term continued smoking and heavy drinking associated with relapse in the short and long term.

Implications: (1) This study suggests that moderate drinking may influence the quit smoking process. Further study is needed to better understand the implications of moderate drinking for smoking cessation. (2) Providing information alone may not be effective in helping people abstain from drinking during smoking cessation, especially if moderate drinkers do not perceive their behavior as reducing their chance for a successful quit attempt. Tailoring smoking cessation interventions to include strategies to reduce moderate-to-heavy alcohol consumption may improve smoking cessation outcomes among alcohol users attempting to quit smoking.