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.     

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.     

Alcohol consumption, smoking urge, and the reinforcing effects of cigarettes: an ecological study.

Smokers (N=74) who volunteered for a smoking cessation study monitored their daily experiences for up to 6 weeks prior to the quit date. Self-reports from 7,707 diary records were used to examine the associations among alcohol consumption (present in 607 diary records), situational factors, smoking, urge to smoke, and subjective consequences of smoking. Alcohol use, smoking urge, and the subjective effects of smoking were context dependent. Momentary reports of smoking and alcohol consumption were associated with one another. Alcohol use predicted smoking even when contextual factors were covaried. Alcohol use was associated with more frequent reports of urge to smoke. Alcohol was also associated with more frequent reports that the last cigarette produced a rush/buzz, was good tasting, and reduced the urge. However, effects for rush/buzz and urge reduction were qualified by interactions between alcohol use and the latency since smoking. Rush/buzz tended to be associated with alcohol use, regardless of smoking recency. Alcohol was associated with urge reduction only when the cigarette being appraised was smoked more than 15 minutes prior to the diary entry.     

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.     

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.     

Social anxiety, reasons for drinking, and college students

Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college students (61.0% women) completed an interview assessing drinking behaviors and questionnaires measuring social anxiety, drinking motives, and drinking situations. Although college men and women both reported similar frequencies of drinking in positive situations and to enhance positive emotions, women reported drinking more often in negative situations and to cope with aversive emotions than men. Mediated moderation analyses suggested that women with social anxiety may be at greater risk of encountering adverse consequences because of their likelihood to drink to conform or to cope with the aversive affect they experience in negative situations. Conversely, when men experience high rates of adverse consequences, it may be due to drinking greater quantities of alcohol in positive situations. Highly socially anxious college men may drink less alcohol and experience fewer adverse consequences than their nonanxious or mildly anxious counterparts because they may find themselves in positive situations and drinking to enhance positive feelings less often, potentially due to avoidant behavior. These findings may help to explain why social anxiety serves as a potential risk factor for alcohol-related problems for college women, but a protective factor for college men.     

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.     

Reasons for substance use among people with psychotic disorders: method triangulation approach

Substance use disorders (SUD) are common among people with psychotic disorders and are associated with many negative consequences. Understanding the reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. We examined reasons for tobacco, alcohol, or cannabis use among people with psychotic disorders. Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi-structured qualitative interviews. Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol, and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Prevention and intervention strategies targeting coexisting psychotic disorders and SUD may improve in effectiveness if they address the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and if they encourage cannabis users to seek alternative pleasurable activities.     

Daily alcohol use and romantic relationship functioning: evidence of bidirectional, gender-, and context-specific effects

Whether beneficial or harmful, cause or effect, the nature of associations between drinking and close relationship processes remains unclear. The present study examined these issues by using daily reports of alcohol use and relationship functioning from 69 heterosexual couples over 3 weeks. Multilevel modeling indicated that alcohol had both positive and negative effects on relationship processes and that effects were more positive for women, and when small amounts were consumed, partners drank together, or they consumed similar amounts. Interestingly, however, positive effects on intimacy and partner behaviors were not mediated by sexual contact. In the reverse direction, women were found to drink more than men in response to relationship difficulties and feeling disconnected from their partner (i.e., low intimacy). Overall findings indicate that associations between drinking and relationship processes are complex and bidirectional and that they may be more important for women than men.     

Factors related to cigarette smoking and alcohol use among adolescents

Based on a national survey of Icelandic adolescents, this study examined the various predictors of cigarette smoking and alcohol use. It was found that the use of tobacco and alcohol was related to a number of different factors: sex, residence, hours of paid work, physical activities, social network, educational performance and beliefs, and psychological distress. Further, smoking and drinking had most predictors in common. It was concluded that existing theoretical perspectives on juvenile deviance do not provide an adequate account of adolescent smoking and drinking. The need to integrate existing theories into a wider explanatory framework is discussed.     

Personal and social correlates of alcohol consumption among mid‐adolescents

A prospective, cohort survey of 540 mid‐adolescent students was conducted to identify personal, family and social correlates of alcohol use. A structured questionnaire recorded alcohol involvement, other substance use, perceived parental alcohol use and related factors, alcohol‐related attitudes and beliefs, psychological well‐being, social and peer behaviours, and school conduct problems. Participants drank on 17.5 days in the past 3 months; on a typical drinking day they consumed 4.7 units, with 28.5% reported drinking six or more units. More frequent drinking was independently correlated with being male, perceiving that parents encouraged drinking, drinking without parental knowledge, drinking to alter mood, buying alcoholic beverages, spending more time with friends who drink, perceiving social pressure to drink, and being excluded from school and truanting. Parental discouragement for alcohol was related to more frequent drinking in females and less frequent drinking in males. Drinking more intensively was associated with use of cannabis, parental encouragement to drink, spending more time with friends who drink, school exclusion, and being in trouble with teachers. These results highlight multidimensional correlates of drinking during mid‐adolescence and underline the importance of addressing personal, family, peer, and school conduct factors in school‐based alcohol education programmes.     

College Students With Military Experience Report Greater Alcohol-Related Consequences

This study examined associations among military experience, alcohol use, and alcohol-related consequences among a large national sample of 27,249 students pursuing postsecondary education. Because of the uniqueness of the developmental period of emerging adulthood, we stratified all analyses by age groups of 18–24 and 25 and older. There were no differences between students with and without military service history in terms of 3 indicators of alcohol use: alcohol consumption in the last 30 days, binge drinking in the last 2 weeks, and drinking and driving in the last 30 days. There were, however, several differences in self-reported consequences of drinking. Among individuals ages 18–24, students with military service history had nearly twofold increased odds of police encounters as a consequence of drinking (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] [1.02, 3.57]) and increased odds greater than twofold of experiencing nonconsensual sex (aOR = 2.68, 95% CI [1.17, 6.19]). Among both age groups, students with military service history reported greater odds of having unprotected sex as a consequence of drinking when compared to students without military service history. Research is needed to identify the reasons why alcohol use results in these particular negative consequences for students with military service history, which can inform prevention and intervention efforts.     

Perceived consequences of drinking caffeinated beverages

A survey of 238 college students indicated that those who prefer to drink caffeine containing drinks maintain different perceptions about the negative and positive consequences of drinking caffeinated drinks from those who do not prefer to drink caffeinated drinks. 154 of the students reported that the last soft drink they consumed was caffeinated.     

Smoking patterns and dependence: contrasting chippers and heavy smokers

The authors used ecological momentary assessment to contrast smoking patterns among chippers (CHs; n = 26)--smokers who smoke despite an apparent absence of tobacco dependence--with those seen in heavy smokers (HSs; n = 28). Smoking and nonsmoking settings (activity, mood, etc.) were assessed by means of electronic diary. CHs were not social smokers; like HSs, they smoked half their cigarettes while alone. When smoking, CHs' urge levels equaled those of HSs; between cigarettes, CHs had few urges, whereas HSs reported moderate urges. CHs' smoking was particularly associated with indulgent activities: relaxation, socializing, eating, and drinking alcohol. Outside of these indulgent settings, CHs' (but not HSs') smoking was associated with negative affect. In idiographic analyses, CHs' smoking was under much stronger stimulus control than was that of HSs. The authors propose that the disappearance of stimulus control over use is a characteristic of dependence.     

Alcohol and tobacco cessation in alcohol-dependent smokers: analysis of real-time reports.

Alcohol-tobacco interactions and relapse precipitants were examined among alcohol-dependent smokers in a trial of concurrent alcohol and tobacco treatment. After discharge from treatment, participants completed 14 days of electronic diary (ED) assessments of mood, self-efficacy, urges to drink or smoke, and drinking and smoking behavior. ED data revealed an increase in frequency of alcohol urges after smoking episodes. Drinking relapse episodes were predicted by prior ED ratings of low self-efficacy to resist drinking and high urge to smoke. Smoking relapse episodes were predicted by high urge to smoke and high negative, high arousal mood. Results support a cross-substance cue reactivity model of multiple substance use and a limited-strength model, but not a cross-substance coping model.     

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.     

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.     

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences—namely positive social experiences—that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.     

Alcohol consumption, drinking patterns, and alcohol problems among managerial versus non-managerial women and men

In the present study, we examined alcohol consumption and alcohol problems between managerial and nonmanagerial men and women. We also examined alcohol problems as a function of drinking context (i.e., when they drink and with whom they drink) for each of these four groups. Survey data and data from company records were collected from a large sample of blue and white collar employees (n = 2279). Participants completed a detailed questionnaire aimed at assessing many work-related attitudes, general mental and physical health-related perceptions, motivations for alcohol use, alcohol consumption indices, and alcohol problems. We found that several of the demographic variables differentially predicted alcohol consumption and problems for the four groups. In addition, drinking alone and immediately after work were associated with alcohol problems for women managers at a significantly higher rate than for the other groups of employees. These results support the assertion that more complex models are needed to understand the linkages between work and alcohol use. The research reported in this paper was supported by Grant AA 10690-02, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health.     

Alcohol consumption, drinking patterns, and alcohol problems among managerial versus non-managerial women and men

In the present study, we examined alcohol consumption and alcohol problems between managerial and nonmanagerial men and women. We also examined alcohol problems as a function of drinking context (i.e., when they drink and with whom they drink) for each of these four groups. Survey data and data from company records were collected from a large sample of blue and white collar employees (n = 2279). Participants completed a detailed questionnaire aimed at assessing many work-related attitudes, general mental and physical health-related perceptions, motivations for alcohol use, alcohol consumption indices, and alcohol problems. We found that several of the demographic variables differentially predicted alcohol consumption and problems for the four groups. In addition, drinking alone and immediately after work were associated with alcohol problems for women managers at a significantly higher rate than for the other groups of employees. These results support the assertion that more complex models are needed to understand the linkages between work and alcohol use. The research reported in this paper was supported by Grant AA 10690-02, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health.