Smoking in alcohol recovery can reduce cognitive performance, and may increase the risk of relapse. Should alcoholics try to quit smoking at the same time as they try to quit drinking?

Clinical research studies of drinking alcoholics that compared smoking drinkers and non smoking drinkers had previously revealed that those heavy drinkers that also smoked performed more poorly on a host of cognitive tests. Smoking seems to co join with alcohol in the brain in some way and exacerbates the damage done by the alcohol, and as such if you are a heavy drinker you would do well to at least quit smoking, if not quit drinking as well. But no one had ever studied the effects of cigarette smoking on mental recovery during initial sobriety.

Researchers at the University of California at San Francisco decided to change that and did a clinical study comparing mental recovery in both non smoking recovering alcoholics and smoking recovering alcoholics; and they found that the cognitive deficits associated with smoking while drinking seem to continue during recovery, with smokers in recovery performing significantly worse on a battery of cognitive tests during the initial 6 to 9 months of sobriety.

Testing done on higher processing, on spatial performance, on short range memory, and problem solving skills all showed a much slower rate of recovery for the smoking abstinent alcoholics when compared to the non smoking groups.

The study results are especially pertinent to alcohol abuse recovery as estimates put the percentage of heavy drinkers that also smoke at 300% to 500% the national average for tobacco use, and as a result a significant percentage of recovering alcoholics are also smokers, and a significant percentage of these people are having their recovery delayed by their tobacco usage.

The study leaders as a result have called for more testing to be done, and since the mortality rates associated with smoking far exceed the mortality rates of drinking, the leaders of the study propose that smoking cessation should possibly be encouraged as a part of the treatment for an alcohol addiction.

The study leaders stop short of saying that smoking increases the probability of relapse, but the when considering deficits in problem solving and higher order processing; it seems likely that smoking may play a role in the recidivism amongst recovering alcoholics. One of the best ways to minimize the risk of relapse is through cognitive strategies leading away from abuse, and good healthy problem solving skills designed to minimize life stresses that also make abuse more likely. Since the study researchers claim that the mental processing required for the enactment of these strategies is impaired by tobacco usage, it seems probable that smoking reduces the effectiveness of cognitive modification therapy, and leads to a higher percentage of relapse.

Additionally, scientists have discovered that there is in fact a co addiction to nicotine and alcohol together and they suggest that by continuing to use nicotine, you are in fact increasing the mental cravings for the co joined addiction to alcohol.

So it seems pretty clear that drinkers trying to get sober should also quit smoking at the same time… which when you think about it may be a pretty tall order. I mean quitting drinking is really hard, and for most people recovery is the most challenging thing they've ever attempted; and since quitting smoking is also no picnic, then isn't combining these two programs of cessation at the same time asking a bit too much out of the recovering addict?

I am no longer a smoker, but I was a smoker while drinking, and I remained a smoker through the first two years of sobriety, and I guess that my tobacco usage was limiting my cognitive recovery, but I'm not sure if I could have quit these two very addictive habits at the same time. I'm neither a scientist nor an addictions professional, I'm just an addict with a bit of experience on recovery, but it would seem to me that by asking too much you increase the odds of failure.

I would say quit smoking if you can, but worry about the drinking more, and even though quitting smoking seems to improve your recovery, if the stress of the smoking cessation drives you back to alcohol, it seems a pretty pointless exercise.

I'm sorry for the somewhat conflicting information and opinion of this post, but this…like so much else about addiction and recovery, seems to be less than crystal clear. If you can quit smoking, you should do it, and you'll feel better, and recent clinical data indicates that you may even think better; but if you can't and you’re just barely holding on in your battle against alcohol, I'd think you might want to wait a few months before taking on another stressor, and another battle against addiction.

Just my 2 cents worth!