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Make that a double


New research shows that people who want to quit smoking can boost their chances of success if they also cut back on drinking or stop altogether.

That’s because alcohol causes smokers to metabolize the nicotine in cigarettes more quickly — leading to strong cravings for more cigarettes.

Sarah Dermody, an assistant professor at Oregon State University and the study’s lead author, said the rate at which different people metabolize nicotine was thought to be stable. But the research shows people can lower how quickly their bodies process nicotine.

“From a clinical standpoint, that’s a positive thing, because if someone wants to stop smoking, we may want to encourage them to reduce their drinking to encourage their smoking cessation plan,” Dermody said.

Researchers had already discovered that people who metabolize nicotine quickly have a harder time quitting, even when they use nicotine replacement products like gum or patches.

Dermody’s study of 22 people showed that men in treatment for alcoholism curbed their drinking from 29 drinks per week to 7. Cutting back on alcohol caused their nicotine metabolism rate to drop.

Women in the study started with a low rate of drinking and didn’t significantly reduce their alcohol consumption. They didn’t see a change in their nicotine metabolism rate.

Dermody said a study involving more people — including women with heavy alcohol consumption — would likely show cutting back on drinking could slow the nicotine metabolism rate for both women and men.

“This research is demonstrating the value in addressing both smoking and drinking together,” Dermody said.

Conventional wisdom says it’s too hard to tackle multiple addictions at the same time, but medical and addiction experts are increasingly counseling people to tackle all their addictions at once.

“Quitting any substance is hard alone. But studies are finding now that if you are going to quit tobacco, or any other substance, that you should do that all at the same time. That way you’re going through all the withdrawals at the same time. It’s actually preparing your body to be healthier and to heal in a quicker time,” said Joy Kilishek, a Medford-based tobacco cessation outreach coordinator for AllCare Health.

Other studies have shown that nicotine and alcohol dependence feed off each other.

Smokers have a five to 10 times greater risk of developing alcohol dependence than nonsmokers, but it wasn’t clear if the smokers started with a greater tendency toward addiction — what some call an “addictive personality.”

In a 2015 study, scientists with The Scripps Research Institute in California found exposure to nicotine creates a fast-track to compulsive alcohol consumption.

The scientists allowed rats to drink alcohol and saw they consumed the human equivalent of one to two beers.

The researchers then induced alcoholism in the rats in two months by exposing them to alcohol vapor. When the rats were offered the chance to drink alcohol, they upped their drinking to the human equivalent of a six-pack of beer.

Rats exposed to both alcohol vapor and nicotine began downing the equivalent of a six-pack of beer in just three weeks.

“We had never seen such a rapid escalation of alcohol drinking before,” said institute biologist Olivier George, a senior author of the study.

When researchers added a bitter compound to the liquid alcohol, most of the rats that had only been exposed to alcohol vapor reduced their drinking. But the alcohol vapor and nicotine-exposed rats kept drinking — indicating that their behavior had become compulsive.

Previous studies showed nicotine activates both the pleasurable reward and unpleasant stress pathways of the brain. Alcohol, a sedative, may calm the stress response — causing smokers to crave alcohol when they light up.

A 2015 study by Missouri neurologists found that nicotine, a stimulant, counters the sleep-inducing effects of alcohol.

People who are drinking and smoking may underestimate how drunk they are, and they may stay awake and active longer — consuming more alcohol and cigarettes.

The vicious cycle of nicotine and alcohol use also carries health risks that range from higher rates of throat and esophageal cancer to hardening of the arteries, a contributing factor to strokes and heart attacks, scientists have found.

But there is hope.

Various medications are available to help curb cravings and ease withdrawal symptoms from tobacco, alcohol and other drugs.

Kilishek recommends consulting with a health care provider to find out which ones can be used at the same time, and to make sure they don’t have negative interactions with other prescriptions a person is taking.

The Oregon Health Plan and many insurance companies cover addiction treatment medication.

Alcohol treatment programs, Alcoholics Anonymous groups and quit smoking groups can all help people gain the skills to tackle addiction.

“It’s a great experience being with other people who are going through the same journey,” Kilishek said.

When it comes to drinking and smoking, she said, routine plays a big role.

Consider the times and places you are likely to drink and smoke, then plan out alternatives.

Instead of drinking an alcoholic beverage, reach for juice, or add lemon, lime or strawberries to sparkling water. They key is to make the replacement enjoyable, Kilishek advised.

In addition to cutting out alcohol, get rid of other smoking triggers like lighters and ashtrays. Thoroughly clean your car to reduce smoke odors, she said.

Staying busy is key to breaking any addiction. Exercise is an ideal healthy alternative because it causes the brain to release the pleasurable chemical dopamine, she said.

“That’s why it’s such an exciting thing for people when they start to exercise. They actually crave that feeling because it feels so good,” Kilishek said.

As people cut out unhealthful habits, they often want to start drinking more water, walking and visiting the gym.

“It’s an automatic progression to want to be healthy,” said Kilishek, who gives out pedometers in her quit-smoking groups to people who want to count their daily steps.

Other ways to keep your hands and mind busy include writing in a journal, coloring and other art projects, squeezing a toy or ball and putting a cinnamon-flavored toothpick in your mouth.

A former smoker herself, Kilishek said positive self-talk is another key to success.

“So many of us are used to saying, ‘I can’t do this. I can’t quit. I’ve tried before. I’m going to die before I quit,’” she said.

Above all, Kilishek said it’s important to take any setbacks in stride.

“Having a slip when you’re quitting smoking is a natural part of the journey. And I tell people, ‘Don’t beat yourself up. It happens. You had a slip, you had a cigarette. Forgive yourself and move on. Keep moving forward. You don’t want to go backward on this journey. Keep going forward. It’s part of the process,’” she said.

Kilishek leads a free drop-in support group for people who want to quit tobacco, from 1 to 2 p.m. every Monday in Room 2194 of the Jackson County Health & Human Services building, 140 S. Holly St., Medford.

She offers tips for dealing with urges and triggers, making healthy choices and learning coping skills. All ages are welcome.

Kilishek also is launching six one-hour tobacco cessation workshops that are free and open to all. The workshop group will meet from 3 to 4 p.m. Thursdays from Jan. 17 through Feb. 21 in Room 2200 of the Jackson County Health & Human Services building. To register for the workshops or for more information, call 541-471-4106.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.

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