Nicotine-Patch Works, If You're Sober

Options Unclear for Recently Sober Alcoholics

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Quitting Nicotine Difficult for Drinkers. © Getty Images

The National Institute on Alcohol Abuse and Alcoholism estimates that as many as 80 to 95 percent of alcoholics smoke cigarettes, a rate three times greater than the general population.

Science is not exactly certain what the relationship is between smoking and drinking, nor do we fully understand why smokers who have a history of alcohol use disorders are more nicotine dependent that people who smoke just as much who have no alcoholism history.

For alcoholics who are still currently drinking, trying to quit smoking, even with aids like nicotine patches, is almost impossible. If they have a drink in one hand, they have to have a cigarette in the other.

The same is true for alcoholics who are very new to sobriety. There is some research that shows that trying to quit smoking can trigger a drinking relapse in some smokers with a history of alcohol abuse.

But, there is good news for alcoholics who have built up some time in sobriety. Research at the University of Vermont has found that nicotine replacement therapy (NRT) works as well for smokers with long-term sobriety as it does for smokers without a history of alcoholism.

Sober People Can Quit Smoking

"This study refutes the common perception that smokers with a history of alcoholism have more difficulty quitting smoking and are likely to relapse back to alcoholism," said John R. Hughes, professor of psychiatry at the University of Vermont and lead author of the study.

"Our results suggest smokers with this history need to be encouraged to attempt to stop smoking."

"For 85 percent of smokers with past alcoholism, quitting smoking is not a problem. Furthermore, as our findings indicate, we found smokers with past but not current alcoholism were able to quit as well and benefited from nicotine-patch treatment to the same degree as smokers without this history," Hughes said.

Studying Nicotine Patch Use

Previous studies revealed that nicotine patches were effective for heavy smokers without a history of alcoholism. The Vermont researchers wanted to see if the same was true for heavy smokers with at least five years sobriety.

They recruited 115 heavy smokers (78 males, 37 females) who were sober more than five years from Alcoholics Anonymous groups, outpatient treatment programs and media advertisements. They were given a 21 mg. nicotine patch or a placebo.

The researchers used breath and urine tests to confirm or not if the participants were abstinent from smoking, alcohol and other drugs.

Patch Helps Smokers Quit

"These findings are consistent with other studies of smokers with long-term sobriety," said David Kalman, assistant professor of psychiatry at Boston University School of Medicine. "First, quit rates of smokers with and without a history of alcohol dependence are similar. Second, NRT is neither more nor less effective for smokers with or without a history of alcohol dependence. Note that 'long-term sobriety' is not precisely defined, but most smokers in these studies have at least a year of sobriety and the median length of sobriety is typically around five years.

"By contrast, other studies have found that smokers with less than a year of alcohol abstinence have greater difficulty quitting," he said.

Will Not 'Jeopardize Sobriety'

"People in long-term recovery who use the nicotine patch in combination with counseling can and do quit smoking; and they are no less successful than smokers without such a history," Kalman said.

"Future research should focus on identifying effective treatment approaches with smokers in early recovery," he said. "We should also continue to examine the effect, if any, of trying to quit smoking on sobriety, particularly for people in early sobriety.

However, consistent with the preponderance of data, I believe that we should be encouraging all smokers in alcohol recovery - including those with less than a year of sobriety - to consider quitting smoking and that we should certainly not be discouraging them to try to quit on the assumption that it will jeopardize their sobriety."


Hughes, JR, et al. "Efficacy of Nicotine Patch in Smokers With a History of Alcoholism." Alcoholism: Clinical & Experimental Research June 2003