title: Current insights into the mechanisms and development of treatments for heavy drinking cigarette smokers.
abstract: There is a strong association between cigarette smoking and alcohol use at the epidemiological, behavioral, and molecular levels, and this co-use creates substantial impediments to smoking cessation among smokers who are also heavy drinkers. Compared with individuals who only smoke, those who both drink and smoke heavily experience more severe health consequences and have greater difficulty in quitting smoking. During smoking abstinence, greater alcohol use is associated with decreased odds of smoking cessation, and smokers are substantially more likely to experience a smoking lapse during drinking episodes. As heavy drinking smokers are less responsive to the currently available pharmacological treatments, this subgroup of high-risk substance users possesses a unique clinical profile and treatment needs. Thus, treatment development for heavy drinking smokers represents a significant and understudied research area within the field of smoking cessation. This review will briefly describe findings from epidemiological, behavioral, and molecular studies illustrating alcohol and tobacco co-use and identify how the behavioral and neurobiological mechanisms underlying the interaction of alcohol and nicotine may inform the development of targeted treatments for this unique population of smokers.
authors.affiliation: University of California, Los Angeles, Department of Psychology, Los Angeles, CA, 90095, USA.
authors.forename: Daniel J O
authors.initials: DJ
authors.lastname: Roche
authors.affiliation: University of California, Los Angeles, Department of Psychology, Los Angeles, CA, 90095, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90095, USA.
authors.forename: Lara A
authors.initials: LA
authors.lastname: Ray
authors.affiliation: University of California, Los Angeles, Department of Psychology, Los Angeles, CA, 90095, USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Yardley
authors.affiliation: University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL 60637, USA.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: King
keywords: Heavy drinking smokers; alcohol use disorder; comorbidity; pharmacotherapy; tobacco use disorder; treatment