Does smoking hamper treatment for alcohol abuse?

According to findings by the University at Buffalo Research Institute on Addictions (RIA), clients who smoke have shorter stays in alcohol treatment programs than non-smokers and may have poorer treatment outcomes than non-smokers.

Kimberly Walitzer, PhD, deputy director and senior research scientist at RIA, led the study, which analyzed more than 21,000 adult treatment seekers from 253 community outpatient substance abuse clinics across New York State.

"The data suggest that smoking is associated with difficulties in alcohol treatment," Walitzer says. "Tobacco smokers had shorter treatment durations and were less likely to have achieved their alcohol-related goals at discharge relative to their nonsmoking counterparts.

"This should be a major concern for treatment providers, as the majority of people with alcohol disorders are, in fact, smokers," she explains.

According to the Centers for Disease Control, less than 20 percent of people in the U.S. are regular smokers. However, a much higher percentage of people with alcohol use disorders are smokers. Further, both smoking and problem drinking are associated with life challenges such as unemployment, lack of high school diploma or GED, criminal justice involvement, mental illness and/or other substance abuse.

For women, these associations are even stronger. Although less than 15 percent of women smoke in the general community, Walitzer's data indicate that 67 percent of women seeking alcohol treatment were smokers, compared to 61 percent of the men. Unfortunately, the study's results show that women who smoke have even more difficult circumstances and poorer alcohol treatment outcomes than men who smoke.

What is the solution? "Previous research indicates that if people can quit smoking when entering alcohol treatment, they may have better alcohol outcomes," Walitzer says. "However, simultaneous cessation is a task that is very challenging to accomplish."

The study appears in the journal Substance Use and Misuse, and its co-authors are RIA's Ronda L. Dearing, PhD, senior research scientist; Christopher Barrick, PhD, senior research scientist; and Kathleen Shyhalla, PhD, data analyst. It was funded by the National Institute on Alcohol Abuse and Alcoholism.