title: Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers.
abstract: The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse.
  
  
  
  The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants' daily lives.
  
  
  
  Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493-5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were re-assessed following cue exposure.
  
  
  
  Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving.
  
  
  
  Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA. tomko@musc.edu.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Tomko
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA.|Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, 29425, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Saladin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA.
authors.forename: Erin A
authors.initials: EA
authors.lastname: McClure
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Squeglia
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA.|Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, 29425, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.affiliation: University at Buffalo, State University of New York, Buffalo, NY, 14228, USA.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Tiffany
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA.
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425-8610, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gray
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D066249:Craving; D003463:Cues; D000072860:Ecological Momentary Assessment; D005260:Female; D006801:Humans; D008297:Male; D000074285:Smokers; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D012931:Social Environment; D013315:Stress, Psychological / Q000523:psychology*; D062789:Tobacco Products; D000073869:Tobacco Smoking; D055815:Young Adult
keywords: Alcohol; Cue reactivity; Ecological momentary assessment; Stress; Tobacco