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August 21, 2014, 11:55 pm

Nicotine and alcohol a risky combination

Smoking and drinking are two of the cultural habits that make for a very dangerous mix. Eighty to 95 percent of people who consume alcohol smoke cigarettes, which is three times higher than the general population. Seventy percent of alcoholics are heavy smokers compared with just 10 percent of the population. Studies also show that smokers tend to consume more alcohol than non-smokers.

This doesn’t mean that everyone who smokes is an alcoholic. The facts do show if you drink and smoke, the habit can kill you. According to a neuropsychologist and neuroscience researcher at the San Francisco Veterans Administration Medical Center, “Smokers tend to consume more alcohol than non-smokers. It is also known that chronic alcohol dependence can damage alcoholics' brains, particularly the frontal lobes, which are critically involved in higher-order cognitive functions such as problem solving, reasoning, abstraction, planning, foresight, short-term memory, and emotional regulation.” Recent data shows that smoking kills more alcoholics than alcohol does.

Alcoholism, also known as alcohol dependence, is a disease that includes the following four symptoms:

Craving – A strong need, or urge, to drink.

Loss of control – Not being able to stop drinking once drinking has begun.

Tolerance – The need to drink greater amounts of alcohol to get "high."

Physical dependence – Withdrawal symptoms, such as nausea, sweating, shakiness and anxiety after stopping drinking.

Alcoholism and smoking are diseases. The craving that an alcoholic and a smoker feel for alcohol or cigarettes can be as strong as the need for food or water. Alcoholics and smokers will continue to drink despite serious family, health or legal problems.

Like many other diseases, alcoholism and smoking are chronic, meaning they can last a person's lifetime. The use of both substances usually follows a predictable course. The risk for alcoholism and smoking is influenced both by a person's genes and by his or her lifestyle.

Alcohol abuse and alcoholism cut across gender, race and nationality. Fourteen million people in the United States or one in every 13 adults abuse alcohol or are alcoholic. More men than women are alcohol dependent or have alcohol problems. Alcohol problems are highest among young adults ages 18-29 and lowest among adults age 65 and older. People who start drinking at an early age greatly increase the chance that they will develop alcohol problems at some point in their lives.

In the United States, one in four people smokes. According to the Surgeon General’s Report “Nearly 40 percent of American Indian and Alaska Native adults smoke cigarettes, compared with 25 percent of adults in the overall U.S. population. They are more likely than any other racial/ethnic minority group to smoke tobacco or use smokeless tobacco.” The Surgeon General’s Report also stated that” Smoking is associated with depression, psychological stress, and environmental factors such as peers who smoke and tobacco marketing practices.”

Dr. David Satcher, surgeon general, said, "Cigarette smoking is the leading preventable cause of disease and death in the United States. We have an enormous opportunity to reduce heart disease, cancer, stroke, and respiratory disease among members of racial and ethnic minority groups, who make up a rapidly growing segment of the U.S. population."

Risk means there is a possibility. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically become an alcoholic too. People have developed alcoholism even though no one in their family had a drinking problem. Not all children of alcoholic families develop problems with alcohol. Knowing you are at risk is important. It can help you take steps to protect yourself from developing problems with alcohol.

What happens when you smoke and drink alcohol? The VA researcher said, “The combined effects of alcohol dependence and chronic smoking are associated with greater regional brain damage than chronic alcoholic drinking or smoking alone.” His studies show that this exacerbation of the alcohol-induced brain damage is most prominent in the frontal lobes of individuals studied early in treatment."

He added, " Results give strong preliminary evidence that chronic cigarette smoking, a behavior that commonly is associated with alcohol dependence, has a significant impact on the integrity of tissue in several brain regions, particularly the frontal lobes and cerebellum, “He said chronic cigarette smoking is also commonly seen in other neuropsychiatric conditions such as schizophrenia, depressive disorders and anxiety disorders.

What makes the combination of smoking and drinking so addictive? One theory holds that nicotine offsets the sedative effects of alcohol. For example, studies have reported that nicotine counteracts the decline in the performance of certain visual tasks and the slowed reaction time induced by alcohol. Alternatively, using nicotine and alcohol in concert might serve to increase the feeling of pleasure associated with either drug alone. Both drugs have been shown to boost brain concentrations of dopamine -- a nerve cell messenger implicated in the positive reinforcement underlying addiction.

Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment:

Stop all cove ups. Family members often make excuses to others or try to protect the alcoholic from the results of his or her drinking. It is important to stop covering for the alcoholic so that he or she experiences the full consequences of drinking.

Time your intervention. The best time to talk to the drinker is shortly after an alcohol-related problem has occurred, like a serious family argument or an accident. Choose a time when he or she is sober, both of you are fairly calm, and you have a chance to talk in private.

Be specific. Tell the family member you are worried about his or her drinking. Use examples of the ways in which the drinking has caused problems, including the most recent incident.

State the results. Explain to the drinker what you will do if he or she doesn't go for help – not to punish the drinker, but to protect yourself from his or her problems. What you say may range from refusing to go with the person to any social activity where alcohol will be served, to moving out of the house. Do not make any threats you are not prepared to carry out.

Get help. Gather information in advance about treatment options in your community. If the person is willing to get help, call immediately for an appointment with a treatment counselor. Offer to go with the family member on the first visit to a treatment program and/or an Alcoholics Anonymous meeting.

Call on a friend. If the family member still refuses to get help, ask a friend to talk with him or her, using the steps just described. A friend who is a recovering alcoholic may be particularly persuasive, but any person who is caring and nonjudgmental may help. The intervention of more than one person, more than one time, is often necessary to coax an alcoholic to seek help.

Find strength in numbers. With the help of a health care professional, some families join with other relatives and friends to confront an alcoholic as a group. This approach should only be tried under the guidance of a health care professional that is experienced in this kind of group intervention.

Get support. It is important to remember that you are not alone. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, which is geared to children of alcoholics. These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.

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