title: Acute effects of low and high dose alcohol on smoking lapse behavior in a laboratory analogue task.
abstract: BACKGROUND
  Smoking lapses (i.e., returns to smoking after quitting) often occur following alcohol consumption with observational data suggesting greater quantities of alcohol lead to greater risk. However, a causal dose-dependent effect of alcohol consumption on smoking lapse behavior has not been established, and the mechanisms that might account for such an effect have not been tested.
  
  
  OBJECTIVE
  In a within-subjects design, we examined the effects of low- (0.4 g/kg) and high-dose (0.8 g/kg) alcohol, relative to placebo, on smokers' ability to resist initiating smoking after acute smoking abstinence.
  
  
  METHODS
  Participants were 100 heavy alcohol drinkers, smoking 10-30 cigarettes per day. Across three separate days, participants consumed placebo, low-dose, or high-dose alcohol following 3 h of smoking abstinence and, 35 min later, were offered the opportunity to smoke while resisting smoking was monetarily reinforced proportional to the amount of time delayed.
  
  
  RESULTS
  Consistent with a dose-response effect, participants smoked 3.35 min (95 % confidence intervals (CI) [-7.09, 0.40], p = .08) earlier following low-dose alcohol and 6.36 min (95 % CI [-9.99, -2.73], p = .0006) earlier following high-dose alcohol compared to drinking a placebo beverage. Effects of dose on smoking behavior were partially mediated by increases in urge to smoke. There was no evidence that alcohol's effects on urge to smoke or ability to resist smoking were mediated through its stimulating or sedating effects.
  
  
  CONCLUSIONS
  Alcohol can reduce the ability to resist smoking in a dose-dependent fashion, in part, due to its effect on increasing the intensity of smoking urges.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA, Christopher_Kahler@brown.edu.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.forename: Jane
authors.initials: J
authors.lastname: Metrik
authors.forename: Nichea S
authors.initials: NS
authors.lastname: Spillane
authors.forename: Anne
authors.initials: A
authors.lastname: Day
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Tidey
authors.forename: John E
authors.initials: JE
authors.lastname: McGeary
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Knopik
authors.forename: Damaris J
authors.initials: DJ
authors.lastname: Rohsenow
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology*; D066249:Craving; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012054:Reinforcement, Psychology; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology*; D055815:Young Adult
chemical_list: D000431:Ethanol