Quitting cigarettes tougher for heavy-drinking smokers, but phone counseling can help

Smokers who drink heavily have a tougher time quitting cigarettes than smokers who drink moderately or not at all. However, a multi-center study led by researchers in Yale Cancer Center and Yale School of Medicine found that modifying tobacco-oriented telephone counseling to help hazardous drinkers can help them quit smoking.

The study was published online Nov. 24 in the Journal of Consulting and Clinical Psychology.

A growing body of research shows that hazardous-drinking smokers are at even greater risk for numerous health problems, including several types of cancer, than smokers who drink less. Also, even if they are able to quit smoking, hazardous-drinking smokers are more likely to relapse. In the study, hazardous drinking was defined as a weekly consumption of at least 14 drinks for men and seven drinks for women at least once in the past year.

Given that 20% of all tobacco quitline callers drink at hazardous levels, the researchers saw an opportunity to explore how telephone counselors could help that subgroup, said the study’s principal investigator, Benjamin A. Toll, associate professor of psychiatry and program director of the Smoking Cessation Service at Smilow Cancer Hospital at Yale New Haven.

The results showed that hazardous drinking smokers who received alcohol counseling and a brochure about reducing drinking were significantly more likely to quit smoking than hazardous drinking smokers who received only tobacco counseling and a brochure about tobacco.

“This was the first quitline study to offer alcohol intervention counseling to hazardous drinking smokers, and we found that the quitline coaches can be trained to counsel that group effectively to improve smoking cessation and limit alcohol use,” Toll said. “If quitlines across the country use this method, we could reach millions of people seeking help.”

The study was supported by National Institutes of Health; the National Cancer Institute; the National Institute on Alcohol Abuse and Alcoholism; the New York State Department of Health;  and the State of Connecticut, Department of Mental Health and Addiction Services. 

Other authors on the study from Yale University were Stephanie S. O’Malley, Steve Martino, Lisa M. Fucito, Sherry A. McKee, Alana M. Rojewski, and Ran Wu; and Christopher W. Kahler, of Brown University; Martin C. Mahoney, Paula Celestino, Srinivasa Seshadri, and James Koutsky, all of Roswell Park Cancer Institute; and K. Michael Cummings, of the Medical University of South Carolina.