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Smoking makes it harder to quit drinking

Constant cravings Contrary to popular opinion, smoking does not make it easier to quit alcohol, and may in fact make the withdrawal process worse.

A study, published today in Proceedings of the National Academy of Sciences, suggests that smoking during alcohol withdrawal interferes with the recovery of a class of receptors in the brain called GABA A receptors.

Researchers used brain imaging techniques to measure GABA A receptor activity at regular intervals over one month in a group of patients being treated for alcohol addiction.

"We found that in people who smoked cigarettes during withdrawal, their brains didn't have the same recovery as the alcohol-dependent people who did not smoke, which suggests that smoking is interfering with the recovery of the brain," says lead author Professor Kelly Cosgrove, Associate Professor of Psychiatry at Yale University.

GABA A receptors play a major role in addiction to both tobacco and alcohol, but during alcohol addiction, the availability of these receptors is altered.

When people stop drinking, it can take a month for a normal balance of GABA A receptors to be restored, Cosgrove says.

The team found a clear link between the number of available GABA A receptors, and the severity of withdrawal cravings.

"We did find that the smokers compared to the non-smokers had almost double the rates of craving for alcohol … and they were correlated with numbers of receptors over the first week of withdrawal," Cosgrove says.

"The known predictor of relapse is having high levels of craving when you quit using a substance, so that's very important, and it may be that continuing to smoke during withdrawal is triggering some of this craving."

The findings suggest that instead of the popular myth being that smoking during withdrawal will make the process easier, it may in fact be better to quit both alcohol and cigarettes at the same time, she says.

Nicotine not to blame

The study also included some research in monkeys, where researchers looked at the impact of nicotine patches during withdrawal.

They found, somewhat surprisingly, that nicotine itself did not seem to be the main culprit affecting withdrawal.

"We really thought that the nicotine, because that's the most addictive part of tobacco smoke, was going to be what was inhibiting the changes in the brain," Cosgrove says.

"But with the animal study it seems that the monkeys that were on alcohol, and on alcohol and nicotine, they had the same changes in their brains and they both looked like the alcohol-dependent non-smokers."

This suggests that something in cigarettes other than nicotine is having a negative effect on alcohol withdrawal.

"I think this is really important because it suggests that you could really safely use any nicotine-replacement therapy instead of smoking [during withdrawal]," Cosgrove says.