'Casual' Smokers at Greater Risk of Hazardous Drinking

16 Times More Likely to Binge Drink

Cigarette and Drink
Smoking Linked to Hazardous Drinking. © Getty Images

Casual smokers, those who are not daily smokers, are less likely to drink alcohol daily, but are significantly more likely to engage in hazardous drinking and develop alcohol use disorders. A study of 5,838 young adults revealed that non-daily smokers are 16 times more likely to engage in hazardous drinking than daily smokers.

Researchers examined data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to find associations between smoking behaviors -- daily smoking, non-daily smoking and non-smoking -- and binge drinking, hazardous drinking and alcohol use disorders.

Compared to non-smokers and daily smokers, casual smokers were five times more likely to meet criteria for an alcohol use disorder diagnosis.

Not Specific to College Students

"The National Epidemiological Survey on Alcohol and Related Conditions provided us with a unique opportunity to investigate these relationships in young adults aged 18 to 25 years," said Sherry A. McKee, associate professor of psychiatry at Yale University School of Medicine, in a news release. "We were able to examine whether associations between non-daily smoking and alcohol use were specific to just college students, or generalized to young adults who were not college students."

"Non-daily smokers are a fast-growing subpopulation of smokers, now constituting at least 25% of all adult smokers in the U.S.," added Saul Shiffman, a professor in the departments of psychology and pharmaceutical science at the University of Pittsburgh.

"Furthermore, this study is important because it sheds light on particular groups defined by age and patterns of smoking and drinking. This can advance our understanding of the range of drinking patterns, and also the developmental trajectory of problem drinking."

Periodic Smoking and Drinking Binges

"We anticipated that the associations between alcohol use and smoking would be greatest in non-daily smokers, but were surprised by the degree of the associations," said McKee.

"While casual smoking was more common in college students, the relationships between smoking and drinking behavior were the same for young adults whether they were students or not."

"Even though non-daily smokers were less likely than daily smokers to drink daily, they were more likely to exceed weekly and daily quantities defined by the NIAAA as hazardous," added Shiffman. "So, even though daily smokers drank more, non-daily smokers drank more hazardously. This, in conjunction with other research, suggests that these casual smokers neither smoke nor drink regularly, but rather may have periodic binges where they may do both, perhaps as they become disinhibited at parties. Drinking and smoking may also mutually promote each other, leading to bouts of heavy drinking and smoking."

Smoke-Free Bars Effective

The authors of the study conclude that smoke-free bans in bars are effective in reducing both smoking and excessive alcohol consumption.

"Currently, the majority of states have enacted smoke-free bans that extend to smoking in venues where alcohol is served," said McKee.

"Research indicates that smoking bans can reduce alcohol consumption in bars, particularly among heavy drinkers."

"Where bans have been imposed on smoking in bars -- notably in Ireland -- they have been met with stiff resistance, but ultimately succeeded, encouraging smokers to quit, and creating more inviting environments for non-smokers in pubs," Shiffman said. "By interfering with the link between smoking and drinking, such policies may also disrupt developmental trajectories towards problem drinking and heavy smoking, and thereby yield a long-term public health benefits as well."

Harrison, E.L.R., et al. "Nondaily Smoking and Alcohol Use, Hazardous Drinking, and Alcohol Diagnoses Among Young Adults: Findings From the NESARC." Alcoholism: Clinical and Experimental Research. 25 September 2008.

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