Littleton John, Barron Susan, Prendergast Mark, Nixon Sara Jo
College of Pharmacy, University of Kentucky, USA.
Alcohol Alcohol. 2007 May-Jun;42(3):167-73. doi: 10.1093/alcalc/agm019.
In general, 'drinkers smoke', and a high proportion of the alcohol-dependent population is also nicotine-dependent. Statistically, the majority of alcoholics will die of smoking-related, rather than alcohol-related, disease. This co-dependent sub-population may have higher levels of nicotine dependence, and find smoking cessation more difficult. Major reasons are that concurrent alcohol use, and/or prior alcohol exposure, may change the reinforcing effects of nicotine, and that each drug becomes a pharmacological cue for the expectation of the other. If so, then smokers whose nicotine dependence is impacted by alcohol, represent a large and distinct sub-population in which both the therapeutic and molecular targets for smoking cessation are altered. This, in turn, has implications for the validity of animal models of nicotine reinforcement, and for the development of novel smoking cessation medications. It is no longer possible to ignore the fact that the two most prevalent and damaging addictive drugs in our society are very commonly used by the same individuals. Without a better understanding of the psychological and pharmacological interactions between alcohol and nicotine that impact dependence, we cannot hope to provide appropriate medications for this large and problematic patient group. Our intention in this opinion overview is to use the current literature to provide a framework for future studies into the impact of alcohol use on the reinforcing effects of nicotine.
一般来说，“饮酒者吸烟”，而且很大一部分酒精依赖人群同时也有尼古丁依赖。从统计学角度看，大多数酗酒者会死于与吸烟相关的疾病，而非与酒精相关的疾病。这种共依赖亚群体可能对尼古丁的依赖程度更高，且更难戒烟。主要原因在于，同时饮酒和/或既往有酒精接触史，可能会改变尼古丁的强化作用，而且每种药物都会成为对另一种药物预期的药理学提示。如果是这样，那么尼古丁依赖受酒精影响的吸烟者就构成了一个庞大且独特的亚群体，其中戒烟的治疗靶点和分子靶点都发生了改变。这反过来又对尼古丁强化动物模型的有效性以及新型戒烟药物的研发产生影响。我们社会中两种最普遍且有害的成瘾药物常被同一批人使用，这一事实已无法忽视。如果不能更好地理解影响依赖的酒精与尼古丁之间的心理和药理学相互作用，我们就无法为这个庞大且问题众多的患者群体提供合适的药物。我们撰写这篇观点综述的目的是利用现有文献为未来研究酒精使用对尼古丁强化作用的影响提供一个框架。
