Concurrent drinking and smoking among college students: An event-level analysis

Cigarette smoking and drinking commonly co-occur among college students, a population that is at high risk for developing alcohol and nicotine use disorders. Several studies have been conducted that have examined predictors of drinking or smoking to gain a better understanding of the antecedents of engaging in these behaviors. Yet, few studies have examined specific factors that influence concurrent smoking and drinking in this population. The current study used data from a 21-day electronic diary-based study of college students (n=86) who engaged in concurrent drinking and smoking to examine event-level associations between alcohol use and cigarette smoking in the student's natural environment. We specifically focused on within-person analyses of contexts in which students reported smoking and drinking simultaneously in comparison to contexts in which students reporting drinking without smoking. Situational contexts included environmental setting, whether s/he was alone or with others, and changes in stress and urges to smoke before initiating drinking. Results indicated that students drank more while smoking and smoked three times as many cigarettes, on average, during drinking episodes. Being with others at a party or a bar was associated with increased odds of smoking while drinking. Likewise, increased stress since the prior assessment predicted a greater likelihood of smoking while drinking. Based on the findings from the present study, it is important for future prevention and intervention efforts to consider social settings and heightened stress among students as potential risk factors for engaging in concurrent drinking and smoking.     

Binge Drinking Among College Athletes and Non-Athletes

Concerns about incidence, forms, and consequences of alcohol use among college students lack examinations of the lifestyles and predictors of college student athletes. This article, using a sample of student-athletes and non-athletes from four Southern universities, identifies the lifestyle predictors for each population, identifying patterns and sets of predictors of binge drinking behavior. Findings indicate that for both samples, binge drinking behavior is explained by sex, drinking in bars, number of male friends who drink, and cigarette smoking. Student-athletes' binge drinking is explained further by residing on campus. Non-athlete binge drinking is related to race and amount of study time per week. Implications for these findings are also discussed.     

Prospective analysis of early lapse to drinking and smoking among individuals in concurrent alcohol and tobacco treatment

The aims of the current study were to examine, prospectively, (a) dynamic changes in affective state, self-efficacy, and urge in the hours before initial smoking and drinking lapses among individuals in concurrent alcohol and smoking treatment, and (b) the extent to which self-efficacy, urge to use, and/or the use of one substance predicted lapse to the other substance. Ninety-six men and women recruited for a clinical trial of concurrent alcohol and tobacco treatment were eligible for inclusion. Only data from those who experienced an initial lapse to drinking (n=29) or smoking (n=32) were included. Two outpatient substance abuse clinics provided concurrent alcohol and smoking treatment on a weekly basis for three months. Ecological Momentary Assessment (EMA) methods were employed over a 28-day monitoring period to assess antecedents to first drink, and a 14-day monitoring period was examined for initial smoking lapses. Baseline and EMA measures of positive and negative affect, alcohol/smoking urge, alcohol/smoking abstinence self-efficacy, nicotine withdrawal, and quantity/frequency of alcohol and tobacco use were examined as lapse predictors. Analyses of EMA ratings controlled for the corresponding baseline measure. Smoking lapse among individuals in concurrent alcohol and tobacco treatment was foreshadowed by higher urges to smoke, lower positive mood, and lower confidence to resist smoking. Drinking lapse was preceded by lower confidence to resist smoking, but only among individuals who reported recent smoking. Concurrent alcohol and smoking treatment should focus on the enhancement of abstinence self-efficacy, positive mood, and the curbing of urges in order to offset lapse risk.     

Longitudinal analysis of the relationship between changes in smoking and changes in drinking in a community sample: the Winnipeg Health and Drinking Survey.

Smoking cigarettes and drinking alcohol are positively correlated in cross-sectional studies of the general population. However, it is unclear whether changes in quantity of drinking over time are related to changes in amount of smoking over time. This investigation examined, with structural equation modeling, the relationship of changes in drinking to changes in smoking over 2 years among 344 adults who reported cigarette smoking and alcohol use at baseline in 1989-1990 or at follow-up in 1991-1992 or both. Surprisingly, no significant relationships were found between changes in smoking and changes in drinking. This lack of effect suggests that changes in the quantity or intensity of drinking and of smoking are not related in any important way in nonclinical populations.     

Early drinking onset: A study of prevalence and determinants among 13‐year‐old adolescents in Norway

Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth‐graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.     

The subjective effects of alcohol-tobacco co-use: an ecological momentary assessment investigation

Alcohol and tobacco use covary at multiple levels of analysis, and co-use of the 2 substances may have profound health consequences. To characterize the motivationally relevant processes contributing to co-use, the current study used ecological momentary assessment (EMA) to examine the subjective consequences of naturally occurring simultaneous use of alcohol and tobacco. Current smokers who reported frequently drinking alcohol (N=259) used electronic diaries to monitor their daily experiences for 21 days. Participants responded to prompted assessments and also initiated recordings when they smoked a cigarette or completed the first drink in a drinking episode. Momentary reports of smoking and alcohol consumption were associated with one another, and these effects remained after adjustment for occasion- and person-level covariates. When participants consumed alcohol, they reported increased pleasure and decreased punishment from the last cigarette. Smoking was associated with small increases in pleasure from the last drink. Ratings of buzzed and dizzy were synergistically affected by co-use of alcohol and tobacco. Co-use was also followed by higher levels of craving for both alcohol and tobacco. Results point to the importance of reward and incentive processes in ongoing drug use and suggest that alcohol intensifies real-time reports of the motivational consequences of smoking more strongly than smoking affects corresponding appraisals of alcohol effects.     

Adolescent gambling and drug use

In this study, 4516 adolescents (aged 11–16 years) completed a questionnaire examining the relationship between underage National Lottery gambling, underage scratchcard gambling, cigarette smoking, drinking alcohol and drug use. It was found that these behaviours were closely linked. Adolescent gamblers reported that they were significantly more likely to drink alcohol (particularly ‘alcopops’), smoke tobacco and take drugs compared to non-gamblers. © 1998 John Wiley & Sons, Ltd.     

Sources of exposure to smoking and drinking friends among adolescents: a behavioral-genetic evaluation

Substance-using friends expose adolescents to models of, and opportunities for, substance use that may lead to its initiation or reinforce existing use. Using genetically informative data from the National Longitudinal Study of Adolescent Health (P. S. Bearman, J. Jones, & J. R. Udry, 1998), the authors examined whether adolescents' exposure to friends' tobacco smoking and alcohol drinking was better explained by family-social or genetic influences. To conduct analyses, the authors constructed substance use exposure scores for adolescent siblings from the responses of siblings' nominated friends to self-reported smoking and drinking items. Using behavioral-genetic analyses of these substance use exposure scores, the authors estimated that 64% of the variance in adolescents' exposure to friends who smoke and drink could be explained by genetic influences, whereas shared environmental influences were zero. These results provide evidence of active, evocative, or both types of gene-environment correlations. Genetic factors can influence the formation of friendships with substance-using peers, thereby contributing to adolescents' exposure to substance use behaviors.     

Parental Predictors of Adolescent Alcohol Use and Alcohol‐Related Consequences

This study examined parental predictors of alcohol use and alcohol‐related consequences among 9th‐grade students (N = 296). Parental disapproval of teen drinking and quality of parent–child general communication were significant predictors of drinking behaviors. Implications for counselors are discussed.     

Exploring Correlates of Alcohol-Specific Social Reactions in Alcohol-Involved Sexual Assaults

This exploratory study examined demographic, assault, and disclosure factors as predictors of survivors’ decisions to disclose preassault alcohol use and social reactions to their preassault alcohol use. Of survivors drinking prior to assault, those with more education and greater alcohol impairment or resistance during assault were more likely to disclose preassault drinking. Of women disclosing preassault drinking, those with more education and more violent assaults received more negative social reactions specific to their preassault drinking. Such negative reactions were more common for those telling parents, police, or medical professionals. Women with less education received more positive and negative social reactions specific to their preassault drinking. Disclosing preassault drinking in greater detail was related to positive social reactions specific to preassault drinking and greater alcohol impairment during assault was associated with both positive and negative social reactions specific to preassault drinking. Implications for research and intervention are provided for survivors disclosing alcohol-related sexual assaults.     

Patterns of alcohol use among rural and small-town adolescents

Much research has indicated that age, gender, grade in school, religiosity, socioeconomic status, and involvement in extracurricular activities are all related to adolescent alcohol use. However, most of such research focuses on urban youth. The present study examines patterns of rural adolescent alcohol use and factors associated with such use. The Student Alcohol Inventory was administered to 650 students in grades 7-12 in a small, middle-Atlantic town and surrounding county. The survey contained sections addressing demographic data, attitudes regarding students' alcohol use, and their parents' use. Along with standard SES measures, items were included on unemployment and receipt of government assistance. The dependent variables included age at first drink, frequency of drinking, amount of drinking, and a composite heavy-drinking index. Eighty-three percent of the respondents indicated that they had drunk alcohol and 57% had had their first drink by age 12. Gender and grade in school were significant predictors of alcohol use for all four dependent variables. Time spent in social activities was significant in predicting all but age at first drink. Religiosity was a significant predictor for only one dependent variable--age at first drink. The SES measures were also weak predictors of drinking behavior. Policy implications and directions for future research are discussed.     

Influences of Parental and Best Friends' Smoking and Drinking on Adolescent Use: A Longitudinal Study1

Many studies have dealt with the relative impact of parents and peers on adolescent substance use. However, only a few studies have explored the role of adolescents themselves in social relationships. Homogeneity in behavioral patterns within friendships can also be generated by selective association. Acknowledgment of selection processes might shed new light on the debate on the influences of parents and friends. This paper examines the impact of parental and best friends' smoking and drinking on adolescents' use, using data (N= 1,063) from a 3-wave, 5-year longitudinal study. The results show that friends' smoking did not affect adolescent smoking over time. Only in early adolescence did friends' drinking exert an influence on subjects' alcohol use. On the other hand, parental use had a small but significant impact on their offspring. Furthermore, support was found for processes of selective association.     

Implicit alcohol and smoking associations among young adult heavy drinkers: Associations with smoking status and alcohol-cigarette co-use

Implicit memory associations may play a role in motivation to use alcohol and cigarettes, but the relationship between implicit associations and co-use of alcohol and cigarettes is currently unknown. This study provided an initial examination of alcohol and smoking implicit associations among young adult drinkers who were either nonsmokers or relatively light smokers (i.e., 10 or fewer cigarettes per day) as a function of smoking frequency and daily-level alcohol-cigarette co-use. Drinkers (n?=?129) completed alcohol-arousal and smoking-valence variants of the implicit association test as well as a daily-level assessment of past 90-day alcohol and cigarette use. Smokers were grouped according to whether they reported daily or nondaily smoking frequency. Results showed that although implicit alcohol-arousal associations did not differ between smokers and nonsmokers, stronger implicit alcohol-arousal associations were observed for nondaily smokers relative to daily smokers after controlling for drinking frequency. Further, implicit positive-smoking associations were stronger for smokers relative to nonsmokers. Within the subgroup of nondaily smokers, more frequent co-use of alcohol and cigarettes was associated with stronger implicit positive-smoking associations when controlling for total drinking and smoking frequency. The findings suggest that implicit alcohol and smoking associations may be linked with smoking patterns (daily vs. nondaily) and co-use of alcohol and cigarettes among young adult drinkers who are not heavy smokers, highlighting the need for more research on the role of implicit associations in the co-use of cigarettes and alcohol.     

Alcohol and nicotine intake and prenatal level of androgens measured by digit ratio

The purpose of this study was to examine the associations between using unhealthy substances and the digit ratio (2nd to 4th digit length ratio, 2D:4D) which is supposed to indicate the prenatal testosterone level. The subjects were 455 students, 225 women and 230 men. Participants declared their frequency of smoking and alcohol drinking. There was no significant difference in digit ratios between subjects regularly using both nicotine and alcohol and those who took none of them. When analyzing the two substances separately, there was no relationship between 2D:4D and alcohol drinking, whereas left hand 2D:4D was positively related to smoking only for women (nonsignificant trend was observed for right hand). Contrary to the previous study, our results indicate that there is no relationship between 2D:4D and alcohol drinking. There is, however, a subtle influence of prenatal testosterone levels for cigarette smoking habits in the case of women.     

A multiple mediation model of trait worry and hazardous drinking among treatment-seeking smokers: the roles of coping and conformity drinking motives

ABSTRACT

Alcohol use is associated with poorer smoking cessation-related outcomes, and smokers with elevated levels of worry experience greater smoking cessation problems. Yet, little is known about the explanatory mechanisms that may underlie the relationship between trait worry and hazardous drinking among smokers. Therefore, this study explored the explanatory roles of coping and conformity drinking motives in the relationship between trait worry and hazardous drinking outcomes including alcohol consumption, alcohol problems, maximum number of drinks, and the number of prior alcohol quit attempts among treatment-seeking smokers. Participants included 377 treatment-seeking smokers who consumed at least one alcoholic drink in the last year (48% female; 86.2% Caucasian; M _age = 34.83 years, SD = 13.38). Results showed a significant indirect effect of trait worry through coping-related drinking motives in relation to alcohol consumption, alcohol problems, maximum number of drinks, and number of prior drinking quit attempts. These findings were evident after controlling for gender, cigarette dependence, and current psychopathology. These findings suggest that coping drinking motives are one mechanism that may explain the relation between trait worry and hazardous drinking outcomes among treatment-seeking smokers.     

Drinking trajectories following an initial lapse.

Relapse following alcohol treatment is a major problem for individuals who are alcohol dependent, yet little is known about the course of drinking after the initial lapse. In the current study, discrete-time survival analysis and latent growth mixture modeling were used to evaluate the time to first lapse and the trajectories of postlapse drinking in a sample of 563 individuals who received community alcohol treatment. Results showed a decreasing risk of lapsing over time. After the initial lapse, 3 trajectory subgroups provided a parsimonious representation of the heterogeneity in postlapse drinking frequency and quantity, with the majority of individuals reporting light, infrequent drinking. Covariate analyses incorporating demographics, distal risk factors, time to first lapse, and coping behavior as predictors of time to lapse and postlapse drinking trajectories indicated that alcohol dependence and coping behavior were the strongest predictors of lapsing and postlapse drinking behavior.     

Stages of change for health-related behaviours in 18 year-old Australians

Abstract This study investigated the validity of a Stages of Change algorithm with respect to independent measures of physical activity and fitness. dietary intake and alcohol consumption in 18 year-old Ausmlian men (n = 301) and women (n = 282). Stage of Change categories were related to fat and fibre intakes in men and fibre intake in women as well as hit and vegetable intakes in men and women. Physical activity and fitness for men and women also showed significant linear associations with Stage of Change categories. Alcohol consumption was significantly associated with Stage of Change categories for men but not for women although recorded alcohol consumption was very variable for women. However, the algorithm was valid for both men and women when drinking alcohol consistent with national guidelines on safe drinking was used. In summary, with reference to actual health behaviours, the Stages of Change algorithm was valid for young men and women for diet. physical activity and alcohol drinking. Independent behavioural data were not available for smoking behaviours. Using the algorithm, there were significant associations in men between prccontemplation status for diet and drinking and diet and physical activity, in women between diet and smoking and in both men and women between drinking and smoking. Covariance between precontemplation status for different health behaviours therefore suggests the need for multimodal interventions.     

Alcohol Use in Adolescent Twins and Affiliation with Substance Using Peers

Affiliation with substance using peers is one of the strongest predictors of adolescent alcohol use. This association is typically interpreted causally: peers who drink incite their friends to drink. This association may be complicated by uncontrolled genetic and environmental confounds because teens with familial predispositions for adolescent substance use may be more likely to select into social networks where drinking is common. We test this alternative hypothesis using a sample of 1,820 twin and sibling pairs, and their same-sex best friends, from three waves of the National Longitudinal Study of Adolescent Health. Across all three waves, peer report of substance use did not influence adolescent alcohol use when genetic and shared environmental predispositions for drinking were considered. The association between alcohol use and peer behavior may be a spurious association attributable to a shared genetic liability to drink alcohol and associate with peers who drink alcohol.     

Attitudes,knowledge, and use of alcohol in university students

This paper investigated attitudes towards alcohol, knowledge of alcohol, parents drinking behaviour, reasons for drinking and television viewing habits varied in relation to actual drinking behaviour. A sample of 106 University students completed a questionnaire which enabled their classification as non, light, medium and heavy drinkers on the basis of their self-reported consumption levels. Results revealed 9% to be non-drinkers, 22% to be light, 38% to be moderate and 31% to be heavy. They also showed that alcohol drinking habits differed significantly with age, sex, smoking habits and in particular with parents drinking habits. Alcohol drinking habits also differed significantly with knowledge of alcohol, heavier drinkers being found to have a better overall knowledge, but reasons for drinking and attitudes towards drinking did not show any overall difference between the drinking habit categories. Finally, there was no indication that television viewing independently contributed to alcohol beliefs, knowledge, attitudes or habits. The results are discussed in terms of future research implications.     

Correlates of intimate partner psychological aggression perpetration in a clinical sample of alcoholic men

This study longitudinally examined correlates of intimate partner psychological aggression in a sample of 178 men seeking treatment for alcoholism and their partners, building on a previous investigation examining correlates of intimate partner physical aggression (Taft et al., 2010). The men were largely Caucasian; average age was 41.0 years. Participants completed a battery of questionnaires that assessed distal and proximal predictors of psychological aggression perpetration. Distal factors, assessed at baseline, included initial alcohol problem severity, beliefs about alcohol, and antisocial personality characteristics. Proximal factors, assessed at baseline and at follow-ups 6 and 12 months later, included alcohol and drug use, relationship adjustment, and anger. Psychological aggression was assessed at all three time points. Findings showed that both groups of variables were associated with psychological aggression perpetration. Beliefs that drinking causes relationship problems and variables related to alcohol consumption exhibited the strongest associations with psychological aggression. The findings are consistent with theoretical models that emphasize both distal and proximal effects of drinking on intimate partner aggression. Implications for clinical interventions and directions for future research are discussed.