Nicotine dependence and withdrawal in alcoholic and nonalcoholic ever-smokers

J Subst Abuse Treat. 1997 Nov-Dec;14(6):521-7. doi: 10.1016/s0740-5472(97)00049-4.


We compared nicotine dependence and withdrawal in male alcoholic and control ever-smokers, controlling for relevant demographic and clinical variables. Alcoholics were more likely to meet criteria for moderate or severe nicotine dependence and endorse more nicotine dependence symptoms. Symptoms reported more frequently by alcoholics included: (a) using nicotine in larger amounts or over a longer time than intended; (b) continued use despite problems caused or exacerbated by nicotine; (c) marked tolerance; and (d) experiencing characteristic nicotine withdrawal symptoms. Alcoholics also smoked more heavily. Other than "headaches," and "decreased heart rate," alcoholics consistently endorsed nicotine withdrawal symptoms at a higher rate. After controlling for demographic and clinical variables and level of nicotine dependence, only "feel depressed" differed significantly between groups. Our research supports previous findings suggesting that nicotine dependence is more severe in those with a history of alcohol dependence. As a result, alcoholics may experience greater discomfort from nicotine withdrawal upon smoking cessation.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcoholism / complications
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology*
  • Comorbidity
  • Ethanol / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Smoking / epidemiology*
  • Smoking Cessation
  • Smoking Prevention
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / etiology
  • Tobacco Use Disorder / complications
  • Tobacco Use Disorder / diagnosis
  • Tobacco Use Disorder / epidemiology*


  • Ethanol