The Author 2007. Published by Oxford University Press on behalf of the Medical Council on Alcohol.
Introduction to special issue of Alcohol and Alcoholism on alcohol and nicotine
Divisions of Basic Medical Sciences-Pharmacology and Mental Health-Addictive Behaviour, St George's, University of London, Cranmer Terrace, London SW17 0RE, United Kingdom, UK
Interest in research on the combination of alcohol and nicotine stems from the widespread social use of these two drugs together. We know a considerable amount about the adverse effects of each of these drugs individually, and are beginning to understand the processes of development of dependence. However, the combination of nicotine and alcohol has potentially more dangerous and less well studied effects than the separate use of these two drugs. The papers in this Special Issue demonstrate the wide range of these interactions and also some contradictions and the need for more information. I would like to thank all the authors and reviewers who contributed to this Special Issue of Alcohol and Alcoholism for their excellent work. I would also like to thank two sets of authors for their patience when emails, and in one instance a manuscript, vanished into cyberspace during the reviewing procedure. I also express my gratitude to the Editors in Chief, Philippe De Witte and Jonathan Chick, for their invitation to act as Guest Editor for this Special Issue. It has been a most interesting and informative experience and I have been pleased to have the opportunity to extend awareness of the serious problems caused by the combination of alcohol and nicotine and to publicize the valuable research on this topic.
Littleton et al. set the scene for this Special Issue with a review covering both clinical and basic science aspects of alcohol/nicotine interactions. They discuss the reinforcing effects of the two drugs and the importance of considering the combination of the two drugs in animal models and medication development. The adverse effects, both for adults and to the foetus, of alcohol and nicotine are highlighted and the authors identify molecular targets that would benefit further study. The high mortality rates due to tobacco use in abstinent alcoholics illustrate the importance of developing therapeutic treatments for the co-dependence.
The review by Durazzo et al. then examines the literature on the neurobiological and neurocognitive consequences of excessive alcohol use with co-morbid smoking. These authors describe their brain imaging research that illustrates the importance of considering tobacco use in studies on people with alcohol use disorders, and emphasize that public awareness of this co-morbidity needs to be increased. Heffner et al. then review the literature on predictors of motivation to quit smoking and outcome of quit attempts among individuals with alcohol use disorders. The review by Leeman et al. examines reported pharmacotherapy trials on smoking cessation. Alcohol use and smokers with alcohol problems have attracted little attention in this type of study and these authors recommend considerably greater examination of this aspect in future trials.
Basic science investigations are represented in this Special Issue by the paper from Lallemand et al., who found that chronic alcohol treatment and withdrawal in rats, with and without concurrent nicotine administration, resulted in changes in preference for alcohol and in locomotor activity. The proportion of basic science papers to clinical papers in this Special Issue reflects the proportion in those submitted and demonstrates the need for considerably more research on the synaptic and molecular aspects of the interactions between alcohol and nicotine.
The specific dangers of drug use during adolescence are now being recognised and two papers in this Special Issue address this topic. The study by Schmid et al. identified a high risk group of adolescents with substantial levels of both alcohol and tobacco use from an early age. Myers et al. found that among adolescents in treatment for alcohol use disorders, smoking did decline during young adulthood but smoking prevalence remained very high and these individuals therefore had a high risk of developing tobacco-related diseases.
The next four papers are concerned with alcohol and nicotine use in adults. Friend and Pagano conducted an examination of data from Project MATCH which demonstrated greater self-efficacy to resist temptations to drink and less depression were associated with greater likelihood of giving up smoking. Berggren et al. describe their studies showing that nicotine use, whether by smoking or use of smokeless tobacco, is associated with more severe alcohol dependence as assessed by DSM-IV criteria. De Leon et al. demonstrated stable associations between current smoking and current drinking in two geographical populations. Schmidt and Smolka examined differences between alcoholic smokers and non-smokers in two pharmacotherapy trials, and found smoking in those populations was associated with a longer time to first relapse although other factors had considerably more influence on the continuation of abstinence.
Genomic aspects of dependence on different types of drugs are now receiving considerable attention but the genetics of comorbid dependence on alcohol and nicotine has not yet been widely examined. In their paper, Preuss et al. describe relationships between certain DRD2 haplotypes and the extent of smoking and drinking among patients recorded in the Munich Gene Data Bank for Alcoholism. The great majority of clinical research on nicotine dependence has involved cigarette smoking but the studies on other forms of nicotine provide information that can aid interpretation of data on cigarette use. The second paper in this special issue from Berggren et al. showed that, in contrast to alcoholics who smoked cigarettes, those who used smokeless tobacco did not exhibit lower platelet monamine oxidase-B activity compared with non-tobacco users.
The standard of contributions to this special issue has been extremely high and I hope that the content will stimulate further research into this widely abused combination of drugs that affects, damages, and brings to a premature end, such a large number of lives.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||