This study sought to address the following research questions:
- What is the association among smokers in England between a recent attempt to quit smoking and alcohol consumption?
- What is the association among smokers with higher risk alcohol consumption in England between a recent attempt to stop smoking and a current attempt to cut down on their drinking?
The researchers looked at the association among smokers in England between a recent attempt to quit smoking and alcohol consumption. They identified smokers as light or heavy drinkers (light was indicated with an Audit-C score below 5 and heavy was indicated with an Audit-C score greater than 5) and analysed their recent attempt to stop smoking (identified by those who had attempted to quit in the last week with those who had not) and a current attempt to cut down on their drinking.
This was an observational study which means that it cannot demonstrate cause and effect. It may be that smokers choose to restrict their alcohol consumption when attempting to quit smoking to reduce the chance of relapse. Alternatively, it could be that people who drink less are more likely to quit smoking. If this is the case, smokers with higher alcohol consumption may need further encouragement to quit smoking.
Jamie Brown said “We can’t yet determine the direction of causality. Further research is needed to disentangle whether attempts to quit smoking precede attempts to restrict alcohol consumption or vice versa. We’d also need to rule out other factors which make both more likely. Such as the diagnosis of a health problem causing attempts to cut down on both drinking and smoking.”
This study is part of an ongoing Smoking Toolkit Study and Alcohol Toolkit Study, designed to provide tracking information about smoking, alcohol consumption and related behaviors in England. Each month a new sample of approximately 1700 adults aged 16 and over complete a face-to-face computer assisted survey. The Smoking Toolkit Study and the Alcohol Toolkit Study are primarily funded by Cancer Research UK and the NIHR School for Public Health Research respectively.
Alcohol consumption during attempts at smoking cessation can provoke relapse and so smokers are often advised to restrict their alcohol consumption during this time. This study assessed at a population-level whether smokers having recently initiated an attempt to stop smoking are more likely than other smokers to report i) lower alcohol consumption and ii) trying to reduce their alcohol consumption.
Cross-sectional household surveys of 6287 last-year smokers who also completed the Alcohol Use Disorders Identification Test consumption questionnaire (AUDIT-C). Respondents who reported attempting to quit smoking in the last week were compared with those who did not. Those with AUDIT-C≥5 were also asked if they were currently trying to reduce the amount of alcohol they consume.
After adjustment for socio-demographic characteristics and current smoking status, smokers who reported a quit attempt within the last week had lower AUDIT-C scores compared with those who did not report an attempt in the last week (βadj = −0.56, 95 % CI = −1.08 to −0.04) and were less likely to be classified as higher risk (AUDIT-C≥5: ORadj = 0.57, 95 % CI = 0.38 to 0.85). The lower AUDIT-C scores appeared to be a result of lower scores on the frequency of ‘binge’ drinking item (βadj = −0.25, 95 % CI = −0.43 to −0.07), with those who reported a quit attempt within the last week compared with those who did not being less likely to binge drink at least weekly (ORadj = 0.54, 95 % CI = 0.29 to 0.999) and more likely to not binge drink at all (ORadj = 1.70, 95 % CI = 1.16 to 2.49). Among smokers with higher risk consumption (AUDIT-C≥5), those who reported an attempt to stop smoking within the last week compared with those who did not were more likely to report trying to reduce their alcohol consumption (ORadj = 2.98, 95 % CI = 1.48 to 6.01).
Smokers who report starting a quit attempt in the last week also report lower alcohol consumption, including less frequent binge drinking, and appear more likely to report currently attempting to reduce their alcohol consumption compared with smokers who do not report a quit attempt in the last week.
Lead author Jamie Brown, from University College London, England, said:
“These results go against the commonly held view that people who stop smoking tend to drink more to compensate. It’s possible that they are heeding advice to try to avoid alcohol because of its link to relapse.”
Who was involved?
Jamie Brown, Robert West, Emma Beard, Alan Brennan, Colin Drummond, Duncan Gillespie, Matthew Hickman, John Holmes, Eileen Kaner, Susan Michie.
BMC Public Health, 2016; 16 (1) DOI: 10.1186/s12889-016-3223-6