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Study's message to recovering alcoholics: Quit smoking to stay sober

Smokers with a history of alcohol problems who continue smoking are at greater risk of relapsing

Columbia University's Mailman School of Public Health

Adult smokers with a history of problem drinking who continue smoking are at a greater risk of relapsing three years later compared with adults who do not smoke. Results of the study by researchers at Columbia University's Mailman School of Public Health and the City University of New York appear online in the journal Alcoholism: Clinical and Experimental Research.

Most adults who have alcohol problems also smoke cigarettes. Yet while treatments for alcohol abuse traditionally require concurrent treatment for problems around illicit substance use, smoking has not generally been part of alcohol or substance use treatment. According to lead author Renee Goodwin, PhD, the thinking in clinical settings has been that asking patients to quit cigarette smoking while they try to stop drinking is "too difficult," and that continued nicotine dependence would make no difference in the long run.

"Quitting smoking will improve anyone's health," says Goodwin, an associate professor in the Department of Epidemiology at the Mailman School of Public Health. "But our study shows that giving up cigarettes is even more important for adults in recovery from alcohol since it will help them stay sober."

The researchers followed 34,653 adults with a past alcohol use disorder enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who were assessed at two time points, three years apart, on substance use, substance use disorders, and related physical and mental disorders. Only those with a history of alcohol use disorders according to DSM-IV criteria were included in the final sample. Daily smokers and nondaily smokers had approximately twice the odds of relapsing to alcohol dependence compared with nonsmokers. The relationships held even after controlling for factors, including mood, anxiety, illicit drug use disorders, and nicotine dependence.

It's unclear why smoking makes alcohol relapse more likely, but the study's authors point to past research on the behavioral and neurochemical links between smoking and alcohol, and the detrimental effects of smoking on cognition.


Co-authors are Andrea Weinberger, Yeshiva University and Yale University School of Medicine; Jonathan Platt, Mailman School of Public Health; and Bianca Jiang and Renee Goodwin, Queens College and The Graduate Center, City University of New York.

The study was supported by the National Institutes of Health (grant R01-DA20892).

About Columbia University's Mailman School of Public Health

Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit

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