Temporal sequence of incident cigarette, coffee, and alcohol use among AA participants.
BACKGROUND
Cigarettes and coffee are widely used psychoactive substances among alcoholics. Due to the devastating public health impact of alcohol use disorders, it is important to determine if using cigarettes or coffee may influence alcoholism. Previous studies indicate that cigarette smoking is associated with progression of alcohol dependence, but the effects of coffee drinking have yet to be investigated.


OBJECTIVE
To retrospectively determine the temporal sequence of incident cigarette, coffee, and alcohol use and attributed subjective effects in AA participants.


METHODS
Volunteers at all Nashville open-AA meetings (n = 289 [126 women], completion rate = 94.1%) were administered a Lifetime Drinking History modified to also include lifetime cigarette and coffee consumption, as well as coffee consumption and effects questions, the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects Questionnaire.


RESULTS
Average ages (years) at first regular use of alcohol, cigarettes, and coffee were 15.4 (IQR: 13.0-18.0), 16.7 (IQR: 13.0-18.5), and 18.5 (IQR: 14.0-23.5), respectively. In a subset who used all three substances (n = 236;102 women) alcohol consumption preceded cigarette smoking (p < .001) and coffee drinking (p < .001), and cigarette smoking preceded coffee drinking (p < .001); these relationships did not differ by gender.


CONCLUSIONS
Recovering alcoholics started regular alcohol consumption prior to cigarette smoking and coffee drinking.


CONCLUSIONS
In AA participants, coffee does not precede initiation of regular smoking or alcohol drinking as might be anticipated for a gateway drug.
Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232-8650, USA.
Michael S
MS
Reich
Mary S
MS
Dietrich
Peter R
PR
Martin
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D000436:Alcoholics Anonymous; D003069:Coffee; D004326:Drinking; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D003069:Coffee