Co-action and changes in alcohol use during a smoking cessation attempt

Addiction. 2024 Jun;119(6):1059-1070. doi: 10.1111/add.16472. Epub 2024 Mar 14.


Aims: Three smoking cessation studies (CARE, Break Free, Por Nuestra Salud [PNS]) were used to measure changes in average alcohol consumption, binge drinking and alcohol-related problems during a smoking cessation attempt and to explore co-action with smoking abstinence.

Design: CARE and PNS were longitudinal cohort cessation studies; Break Free was a two-arm randomized clinical trial.

Setting: Texas, USA.

Participants: Participants were current smokers who were recruited from the community and received smoking cessation interventions. All participants received nicotine replacement therapy and smoking cessation counseling. CARE included 424 smokers (1/3 White, 1/3 African American and 1/3 Latino); Break Free included 399 African American smokers; PNS included 199 Spanish-speaking Mexican-American smokers.

Measurements: Weekly alcohol consumption was collected multiple times pre and post-quit, and binge drinking and alcohol-related problems were collected at baseline and 26 weeks post-quit. Analyses included only those who indicated current alcohol use.

Findings: Average alcohol consumption decreased from baseline to 26 weeks post-quit in CARE (F = 17.09, P < 0.001), Break Free (F = 12.08, P < 0.001) and PNS (F = 10.21, P < 0.001). Binge drinking decreased from baseline to 26 weeks post-quit in CARE (F = 3.94, P = 0.04) and Break Free (F = 10.41, P < 0.001) but not PNS. Alcohol-related problems decreased from baseline to 26 weeks post-quit in CARE (Chi-sq = 6.41, P = 0.010) and Break Free (Chi sq = 14.44, P = 0.001), but not PNS.

Conclusions: Among current drinkers, alcohol use/problems appear to decrease during a smoking cessation attempt and remain low through 26 weeks after the quit attempt. Little evidence was found for co-action, with smoking abstainers and relapsers showing similar change in alcohol use/problems.

Keywords: alcohol use; binge drinking; co‐action; problematic drinking; race/ethnicity; smoking cessation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol Drinking* / epidemiology
  • Binge Drinking* / epidemiology
  • Black or African American
  • Counseling
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mexican Americans / statistics & numerical data
  • Middle Aged
  • Smoking Cessation* / methods
  • Texas / epidemiology
  • Tobacco Use Cessation Devices
  • White People