Quitlines for Smoking Can Help With Drinking

Smoking cessation hotlines can also help people who drink alcohol at hazardous levels

(RxWiki News) Smoking 'quitlines' are a cost-effective, easy to access tool to help people quit smoking.  Researchers are proposing that quitlines can also help smokers with hazardous drinking habits as well.

New research suggests that, in order to help people quit smoking, the person’s drinking habits may also need to be considered.

Smoking cessation quitlines can not only help people with their journey to quit smoking, but also address heavy drinking.

"Check your local listings for a smoking cessation quitline!"

Benjamin A. Toll, PhD, assistant professor of psychiatry at the Yale University School of Medicine, led a study evaluating the drinking patterns of people who called the New York State Smokers’ Quitline (NYSSQL) for free smoking cessation assistance.

Smoking and drinking alcohol are related. Multiple studies have looked into the links between the two and the effects one habit has on the other.

Toll’s intentions are to discover whether it would be helpful for a smokers’ quitline, like the NYSSQL, to not only help people quit smoking, but also aid and assist those with drinking problems as well.

According to Toll: “Quitlines provide telephone-based treatment services for smokers who want assistance quitting. All quitlines offer counseling and self-help materials. About 75 percent of quitlines also offer free medications.”

Christopher Kahler, PhD, professor at the Center for Alcohol and Addiction Studies at Brown University, adds: “Quitlines have a broad reach, serving about half a million smokers in the US each year, and are able to reach populations of smokers that would otherwise be difficult to provide services to.”

“They are a remarkable success story in taking tested treatment methods, validating them for use in a new format, and disseminating this approach very broadly. Quitlines are available in all 50 states and are common in Europe, Canada, and elsewhere.”

Toll claims the NYSSQL “is one of the busiest quitlines in the country—receiving [more than] 100,000 contacts for assistance in 2010—and is committed to researching innovative treatments to help smokers quit.”

For the study Toll’s team looked at 88,479 people who called into NYSSQL for rates of hazardous drinking. In follow-up interviews, 14,123 and 24,579 participants were contacted, and then three months later another 2,833. The researchers were looking for data that compared people who quit smoking that were hazardous drinkers, moderate drinkers and non-drinkers.

56 percent of callers claimed to drink, 23 percent admitted to drinking levels that are classified as hazardous.

Toll reports: “Our strongest finding was that in a large sample of smokers—almost 90,000 individuals—a relatively high proportion, almost 23 percent, drank at government-defined hazardous drinking level.”

Kahler puts it into perspective: “[T]his study demonstrated that hazardous drinking occurs in almost one out of four quitline callers and can interfere with efforts to quit smoking. The results provide powerful documentation that there are a large number of heavy drinkers who could be served through the quitline system if assessments and brief alcohol intervention were made a part of the quitline protocols.”

But why is this the case? Why do heavy drinkers have a harder time quitting smoking?

Kahler proposes, “There are many potential contributing factors; first, those who drink heavily may have more disrupted lives and more psychosocial stressors. They are likely to have a higher proportion of smokers in their social networks.”

“Finally, drinking alcohol can lead to cravings to smoke, and high levels of drinking may make it more difficult to inhibit smoking behavior during a quit attempt. Results from prior work I have done suggests that heavy drinkers are generally equally motivated to quit smoking as moderate drinkers.”

Toll offers a plan, “Brief alcohol interventions for as short as five minutes have been shown to reduce rates of hazardous drinking. It would be relatively straightforward for quitlines to add in a counseling module specific to hazardous drinkers.”

Kahler suggests the best tactics for helping people quit smoking: “The standard advice is to recommend that smokers avoid drinking alcohol as much as possible when quitting. However, that advice is not very detailed.”

“Our approach in clinical trials has been to provide information on the association between drinking and smoking relapse, assess drinking patterns and their association with quitting, and assess smokers’ willingness to avoid or reduce drinking when quitting.”

“After that, it is important to help smokers set concrete goals for their drinking and to check in on those goals at each session. We have found that even those smokers who make a quit attempt and fail are often able to maintain reductions in drinking.”

This study will be published in Alcoholism: Clinical & Experimental Research, September 2012. Funding for the study was provided by grants from the National Institutes of Health, the National Cancer Institute, the National Institute on Alcohol Abuse and Alcoholism and by the State of Connecticut, Department of Mental Health and Addictions Services.

Review Date: 
June 14, 2012