Cigarette smoking in alcohol and cocaine abusers.

This study compared the cigarette smoking of substance abusers whose primary substance of abuse was cocaine (cocaine group: n = 18) or alcohol (alcohol group: n = 23). Cigarette smoking and smoking topography was assessed daily (via self-report and single cigarette topography assessments) at baseline and following a switch to a cigarette brand with 30% lower nicotine. The alcohol and cocaine groups did not differ at baseline on cigarettes smoked per day, cigarette nicotine, smoking topography, or the Fagerstrom Tolerance Questionnaire. However, the cocaine group exhibited marked increases in compensatory smoking relative to the alcohol group following the 30% reduction in cigarette nicotine, as evidenced by decreases in the average time interval between each puff, p < .05, increases in the total amount of time spent puffing, p < .05, and increases in estimated total amount of time spent puffing per day, p < .05. These findings provide initial data that cocaine and alcohol abusers may titrate nicotine differently and suggest that cocaine abusers may require additional or modified smoking cessation treatments.

Issues related to smoking cessation among substance abusers.

Initial studies have found that stop-smoking treatments for newly recovering substance abusers have been neither harmful to sobriety nor effective in achieving smoking cessation. The development of more effective stop-smoking treatments for this population could be aided by delineating their particular smoking-related characteristics. This article describes the biopsychosocial characteristics of newly recovering substance abusers that are relevant to smoking cessation, and suggests that there are notable differences between abusers and nonabusers that may contribute to abusers' greater difficulty in quitting smoking. It also recommends changes in existing treatment protocols where applicable and identifies key areas for future research.