Can people quit smoking and still drink alcohol?

Can people quit smoking and still drink alcohol?

Joel
Joined: 18 Dec 2008, 23:57

30 Oct 2005, 18:57 #1

Joel's Reinforcement Library
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Can people quit
smoking and
still drink alcohol?
There are different groups of people that must be taken into consideration when addressing alcohol and quitting: people who have never taken a drink in their lives, people who are truly social drinkers, drinkers who consider themselves to be social drinkers but who may in fact have a drinking problem, people who know that they are alcoholics and who have quit drinking, and people who are actively drinking alcoholics. There are different considerations involving quitting for each of these groups.

Never Drinkers

The easiest group of course is people who have never been drinkers and don't plan on ever drinking. There is nothing they need to worry about regarding alcohol consumption when quitting smoking.

Social Drinkers

Truly social drinkers can still drink alcohol without risk of smoking relapse--but being mentally prepared can be crucially important for them. They must go into ALL drinking situations reminding themselves that they are recovering nicotine addicts and that they are going to be recovering nicotine addicts for the rest of their lives.

While that may not sound great in concept--being a recovering nicotine addict--it sure beats being an actively using nicotine addict, hands down. For over time, being a recovering nicotine addict has no real signs or symptoms and no real adverse health or even social effects associated with it. Being an active user would actively be destroying tissue with every puff, depositing cancer-producing chemicals with every puff, assaulting your heart and circulatory system with every puff, costing you money with every puff, and making you reek with every puff.

It is important for these people to know that know that everything that they could do as smokers, they can also do as ex-smokers. They just have to teach themselves how. There are some things that new quitters are forced to learn early on like how to eat, sleep, use the washroom, breathe, etc. These are things that are required from day one for survival. So even though they may resist doing one of them, they can't resist for long and will thereby be forced to start to break the association to smoking early on.

Other things are sometimes put off and seen as unimportant to face early on. Tasks like doing housework, laundry, cleaning, brushing teeth, combing hair, or maybe even going to work and doing their jobs. While it is true that people won't die if they stop doing one or more of these activities for a day or two, putting off doing them too long will create a set of problems that can be quite annoying to those around them.

Besides threatening their livelihood and making them look like slobs in general, if carried on too long, it can really start to make them feel intimidated that they may never again be able to do these activities. Again, it must be repeated, everything a person did as a smoker they can also do as an ex-smoker--but they have to teach themselves how.

Now when it comes to areas of less importance like watching television, sports, playing cards, being a couch potato, and yes, even drinking with friends--things that are not necessary for survival and in fact, things that may not even be good for a person--well, the truth is people can do these things too as ex-smokers.

The same process is necessary though. They have to teach themselves how. Holding off too long can create a sense of intimidation, the feeling that they can never do the specific activity again. This simply is not the case. They will be able to get themselves back to their pre-quitting existence if they choose to.

Drinking is a special case because the association is so strong and by its very nature lowers their inhibitions. It can cause people to do some very irrational behaviors. Smoking can be one of them. Because of the drug's influence, it is best that people take it on gradually, in the beginning in a safe environment.

These people should probably limit themselves to one drink the first time out just to show themselves that they can have a drink without smoking. Also, they should do it with people who are non-smokers and who really are supportive of their quitting. This is a much safer situation in the beginning than going out with drinking buddies who smoke cigarettes and who may be a tad envious of their quitting, and who, while drinking themselves also have their inhibitions lowered. It may manifest in behaviors of encouragement of smoking at a time when the person is more vulnerable.

Soon ex-smokers will be able to face these environments too. Again it is best that they do it gradually, breaking some of the association and intimidation factors in the safer controlled environments. The fact is, though, for the rest of their lives they will need to keep their guard up, in a sense reminding themselves of their reasons for having quit and the importance to stay off smoking, every time before they go drinking. It prepares them to face the situation in a much safer state of readiness.

These people need to use timetables that they are comfortable with, but the sooner they take on activities like drinking the sooner that they will prove to themselves that life goes on without smoking.

Problem Drinkers

The next group is people who define themselves as social drinkers but who do in fact have a drinking problem. These are people who cannot drink in a controlled manner, or people whose drinking at one time has adversely affected their health or caused them any economic, professional, legal, or personal problems.

These people need to think long and hard about whether they are in fact problem drinkers or possibly dealing with alcoholism issues. If a person says that they know that their drinking will cause them to take a cigarette and relapse back to smoking, and then they take a drink and relapse, they are in effect problem drinkers for they have now put their health on the line in order to drink.

Recovering Alcoholics

A person who has acknowledged that he or she is an alcoholic and has successfully quit drinking probably has a rather thorough understanding of addiction. If he or she didn't, he or she would not be successfully off drinking but more likely rather still is an active drinker. People who are successfully recovering from alcoholism probably understand the relapse implications of just one drink, or just one sip.

All a person who has quit drinking needs to do to quit smoking is to just transfer his or her experience and knowledge with alcohol, while aiming it straight at nicotine. The same problem -- drug addiction. The same solution -- stop delivering nicotine into his or her system.

The recovering alcoholic will probably be scared about quitting, feeling that life will never be the same without smoking. " The odds are pretty good that he or she probably had those exact same fears when quitting drinking. The recovering alcoholic was right when he or she thought his or her life would be different. It in all likelihood became immeasurably better. The same will hold true with quitting smoking.

I always state it this way. Treat an addiction as an addiction and a person will learn to control it. Treat an addiction like a bad habit and the person won't have a prayer. Nicotine use is an addiction. If a recovering alcoholic takes his or her understanding of addiction and aims it at nicotine he or she will do fine.

I should point out that whenever I have a person who quits smoking after quitting another substance, he or she often has a harder time quitting than the average smoker. Smoking may have been a crutch used to help them get off of the other substance. Now, when quitting cigarettes, not only is the person trying to break free from a primary addiction, but he or she is also trying to remove the crutch that he or she feels supported recovery from the other addiction.

While it may be harder up front, people recovering from alcoholism or any other addiction can be more prepped for success than the average quitter, for once again, they understand addiction. If the quitter aims their alcohol recovery program at treating this addiction, they will do fine with nicotine dependency recovery, too.

Drinking Alcoholics

The last group is people who are actively drinking alcoholics who want to quit smoking. When it comes to nicotine addiction, the only thing these people need to do to successfully quit smoking is to stop delivering nicotine. Are there other things that some people may also have to get rid of after they quit smoking? Sure there are.

If a person were a diabetic while smoking and not watching his or her diet, he or she would likely have to get his or her sugar intake under control when quitting smoking. The fact is, though, he or she probably needed to get his or her sugar under control when he or she was still smoking. Quitting didn't change that variable. Alcohol is no different. If a person has a drinking problem before quitting, he or she will still have a drinking problem after quitting. Still, all the problem-drinker needs to do to get off nicotine is just to get off nicotine. The drinking problem still exists and still needs to be dealt with.

A person first realizing he or she has an alcoholism problem and who also wants to quit smoking either has to quit both substances at the same time or get drinking under control first. The only reason I say that some people probably need to quit drinking first is because of the limitation of how the person's alcohol treatment program will advise him or her when they find out that he or she is a recent quitter of cigarettes.

Many if not most alcohol recovery programs will inadvertently or very purposely push a new ex-smoker entering the program to smoke. Over the years I have in fact had actively drinking alcoholics in smoking clinics--people who made it abundantly clear that they knew they had drinking problems and smoking problems but wanted to treat the smoking first.

I really do try to get them into alcohol treatment concurrently but cannot force them to do it. On more than one occasion I have seen the person successfully quit smoking, stay off for months and sometime longer, and finally get into AA, only to be assigned a smoking sponsor who tells the person that he or she can't "get off smoking and drinking at once," and who actually encourages the person to smoke again.

Note the sequence here--the ex-smoker has been off of nicotine for an extended time period but the smoking sponsor says that the person can't quit both at once. It is unfortunate that most alcohol and drug treatment programs just don't recognize smoking as another drug addiction.

You will not often see an AA sponsor say that you can't give up drinking and heroin at once, so if you have been off heroin for six months and now want to quit drinking, you should probably take heroin for a while until you get alcohol out of your system.

The bottom line is that there are other things that ex-smokers may need to address but not in order to sustain their quits, but to sustain their health or control other problems. To successfully overcome smoking and arrest a dependency upon nicotine requires only that a smoker make and stick to a personal commitment to Never Take Another Puff.
Joel
© Joel Spitzer 2005
Page created October 29, 2005 and last updated by Joel Spitzer on October 29, 2005

Last edited by Joel on 08 Jul 2010, 12:13, edited 3 times in total.
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Joel
Joined: 18 Dec 2008, 23:57

09 Feb 2007, 20:32 #2

July, 1, 2013 added new video introducing this thread to YouTube viewers:






This was a response that I wrote to a member back in 2000. It addresses the issue of people quitting smoking who are in recovery from other addictions:

From: Joel.      Sent: 9/21/2000 8:45 AM
Hello Christiana:

Let me echo everyone else's welcome and assurance that you are in the right place. Your background in AA will serve you well here. You basically come to us with a thorough understanding of addiction. If you didn't, you would not be a recovering alcoholic but rather, an actively drinking one. You understand the principal of one drink, or one sip for that fact.

Now it is just transferring your experience and knowledge with alcohol and aiming it at nicotine. Same problem, drug addiction--same solution, stop delivering it into your system.

You probably feel quitting is scary, what will your life be like without smoking? Well, you probably had those exact same fears when quitting drinking. You were right when you thought your life would be different. It in all likelihood became immeasurably better. The same will hold true with this effort.

I always state it this way. Treat an addiction as an addiction and you will learn to control it. Treat an addiction like a bad habit and you won't have a prayer. Your use of nicotine is an addiction Christiana. Take your understanding of addiction, aim it at nicotine and you will do fine.

I should point out, whenever I have anyone who quits smoking after quitting another substance; they often have a harder time than many others in the group. Smoking may have been a crutch off the other substance. Now, when quitting, not only are they trying to break free from a primary addiction, but, they are trying to pull off the crutch from the other addiction.

While it may be harder up front, they are usually more successful than the average, again, because they understand addiction. Aim your other program at this and you will do fine.

If anything we can do to help, don't hesitate to ask.


Joel

and this written on the person's one year anniversary:



From: Joel. Sent: 9/21/2001 11:40 AM
 
I see today is Christiana's one year anniversary. Whenever we get new people here who express that they are recovering from other substances, I refer back to Christiana and her original post here. It is important that all people realize that no matter what their past histories may be, whether this is the only addiction they have ever faced or if this is the last of many addictions to be dealt with, quitting is possible for all and staying off is possible to.




I want to personally thank Christiana for helping so many others coming in here thinking that their ability to quit was handicapped by previous problems with other substances. As I state in this string every time I refer to it, previous drug or alcohol experience is more of an advantage than a disadvantage in smoking cessation. For all people who are recovering from any other substance are in fact recovering because they have educated themselves about addiction and its treatment.




Treat and addiction as an addiction and you will control it. Treat an addiction like a bad habit and you won't stand a prayer. Nicotine is an addiction, and if treated as such will always stay under your control. All you need to do to control it for a day, a week, a month, a year, a decade, or in reality, a lifetime is to always remember to never take another puff!



Joel
Last edited by Joel on 01 Jul 2013, 20:42, edited 2 times in total.
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John (Gold)
Joined: 18 Dec 2008, 23:57

26 Mar 2007, 20:39 #3

MYTHS AND DATA RELATED TO
SMOKING CESSATION AND ALCOHOL ABSTINENCE
Myth: Smoking is more benign than alcoholism.
  • More people with alcoholism die from smoking-related diseases than from alcohol-related illness (Hurt et al. 1996).
  • Comorbid smoking and alcoholism result in synergistic exacerbation of health risks (Bien and Burge 1990; York and Hirsch 1995; Hinds et al. 1979).
Myth: Smokers with comorbid alcoholism have either no interest or no ability to quit smoking.
  • The majority (up to 80 percent) of individuals in addiction treatment are interested in quitting smoking (cf. Prochaska et al. 2004).
  • Inclusion of smoking cessation treatment into other addiction programs does not negatively affect rates of treatment completion or motivation for abstinence (Sharp et al. 2003; Monti et al.1995).
  • Alcoholism does not seem to impede specific attempts at quitting smoking (Hughes and Kalman 2005).
  • Alcoholism may make lifetime cigarette abstinence more challenging, but it remains possible (Martin et al. 1997; Prochaska et al. 2004).
Myth: Smoking cessation will impede successful alcohol use outcomes.
  • The majority of research indicates that smoking cessation is unlikely to compromise alcohol use outcomes (cf. Fogg and Borody 2001).
  • Participation in smoking cessation efforts while engaged in other substance abuse treatment has been associated with a 25 percent greater likelihood of long-term abstinence from alcohol and other drugs (Prochaska et al. 2004).
  • Data indirectly suggest that continued smoking increases the risk of alcohol relapse among alcohol-dependent smokers (Taylor et al. 2000).
Link to full text of article discussing the above factors
Last edited by John (Gold) on 10 Apr 2009, 05:31, edited 1 time in total.
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Sal GOLD.ffn
Joined: 16 Jan 2003, 08:00

19 Jul 2008, 06:18 #4

Last edited by Sal GOLD.ffn on 10 Apr 2009, 05:33, edited 1 time in total.
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Joel
Joined: 18 Dec 2008, 23:57

08 Aug 2008, 20:37 #5

We have people here at Freedom who are successfully in recovery from other addictions and many of them likely used a 12-step program to quit. As it says above:
"All a person who has quit drinking needs to do to quit smoking is to just transfer his or her experience and knowledge with alcohol, while aiming it straight at nicotine. The same problem -- drug addiction. The same solution -- stop delivering nicotine into his or her system."

I suspect a number of our members and readers who come from a 12 step background do in fact aim their 12 step program right at smoking.

We probably have more readers and members though who are not from a 12-step background, and we see no reason that these people need to learn or follow a full 12 step program in order to quit smoking. We have incorporated many teachings found in other recovery programs into lessons taught here, such as the"ONE DAY AT A TIME" concept and I think our members who come from a 12 step background appreciate many of the principles that this site is built on.
Video Title Dial Up High Speed MP3`Audio Length Created
People in recovery from other addictions 3.24mb 9.68mb 4.00mb 08:50 11/20/06
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Joel Spitzer
Joined: 13 Nov 2008, 14:04

03 Mar 2009, 22:50 #6

Copied from the post Crutches to Quit Smoking

I just saw a post suggesting a nice way to celebrate being successfully off smoking for a year is to buy a bottle of wine to share with friends and loved ones. It made me think of the original article here and the commentary I attached the other day. The casual suggestion of celebrating successfully not smoking for a given time period with an alcoholic beverage of any kind really does not belong at a site dealing with treating a drug addiction. Are there people who may celebrate this way here at Freedom? Sure there are--I suspect that a lot of our members drink occasionally. But there are some members and readers here who don't drink to celebrate either by personal choice or, because they can no longer drink to celebrate without having to drink all of the time whether there is anything to celebrate or not. These are people who are recovering alcoholics and who hopefully know their own limitations. I suspect that some of these people may be put off by the suggestion of using alcohol to celebrate quitting smoking. Also, there are likely members and readers here who while they may not be alcoholic themselves, they may have family members and friends who are and who may think that buying wine to share with these people is not an appropriate method of celebrating breaking free from the nicotine addiction.

As it says above:


[/size] ...do not use this site to glamorize drinking. There are people here who are recovering alcoholics who find posting about the fun and glamour of drinking to be quite disconcerting. Also, the frequent use of the emoticons, portraying a mug or a champaign toast are really seen as poor taste to these people. Put yourself in their place--if you belonged to a site that was on a totally different topic, and people came in touting the joys of recreational smoking, you would feel the need to enlighten the group or could be offended and annoyed with the casual way the subject was being portrayed. You could then either feel the need to take it head on and stir up debate with the group, or just leave the group. Neither of these options is acceptable to us at Freedom--for we have strict policies about diversional posts, and the idea of a person leaving because of an issue that is really unnecessary is abhorrent to us. Because the people who are here trying to secure their quits are here because they are fighting for their lives. Their needs then take precedent over people who are here for more social or fun reasons. Freedom is a quit smoking education and support site. We try to get the message out that life goes on without smoking--things you could do before can still be done after quitting. Things that could not be done before, such as safe or controlled drinking for a recovering alcoholic cannot be done now either. So as a general rule of thumb now, we are asking members to minimize the amount of time they are posting about drinking at this site. We have ample strings to cover alcohol issues. We will continue to bring them up as holidays come up, and around weekends where drinking situations are often encountered more frequently. But we ask that people who are regular users of alcohol not to raise the issue over and over again.



[/size] All posting members need to stay cognizant of this concept. It is not saying that issues involving drinking cannot be discussed. Again, if a person finds him or herself in a social drinking situation and it creates smoking thoughts, or if a person is nervous about how to get through a party or gathering where he or she will be drinking, it is totally legitimate to raise these concerns and for others to explain how they deal with such circumstances. Suggesting or encouraging the use of alcohol though to others who you do not know their full histories on is a risky proposition.

As we discuss in the thread The Freedom Classroom

Since December of 2002 we have had over 1,056,000 distinct hosts view pages at www.whyquit.com. If only 10% of these people find their way to Freedom it would still be over 100,000 people. The numbers may be higher. While we don't know the exact numbers of people who do read we know it is a lot. Every person posting at Freedom has an awesome responsibility because every word you are writing is capable of influencing hundreds or even thousands of people. Considering what we are trying to influence them to do, which is to quit smoking and to save their lives, it is easy to see how why we feel that this is indeed an awesome responsibility.


So everyone be aware and stay cognizant to the fact any advice written on this board is being read by hundreds to thousands of people. Make sure that any specific suggestions that you are sharing is sound advice for all people. Offering celebratory drinks to all people is an unwarranted suggestion in the event the people who you may be making the offer to are people in recovery from alcohol.

It is similar to our members getting offered a cigar to celebrate the birth of a baby or other special occasions. While the act may seem acceptable to some people in some social circles, I think most of our members and readers would feel that this act would be uncomfortable to say the least, and in poor taste if the offer was being made by a person who knew you had quit smoking, and that you had made it clear to that person that you realize that you are a nicotine addict and cannot smoke without relapsing.

Be prepared that such offers may occur from others. Offers for drinks will likely happen at times even if you are a person who is in recovery from alcohol. Understand that if you are a person in recovery that the reason that you have maintained your sobriety up to this point is that you have worked out some sort of response to deal with such offers and the bottom line is that it is your responsibility to stick to your commitment not to drink.

The same concept holds true for all of our members regarding smoking. I hope most of our members and readers never find themselves feeling that there is a right time to pass along a cigar or any tobacco product to another person to celebrate any event. All members and readers must be aware though that offers of tobacco products to you can occur over time. Once again, it is the personal responsibility of each member and reader to sustain his or her own quit even at such times by remembering that in spite of the nature of these offers that the only way to sustain your own quit and truly have something to celebrate is to stick to your own personal commitment to never take another puff.

Joel


Related Video:
Video Title Dial Up High Speed MP3`Audio Length Created
People in recovery from other addictions 3.24mb 9.68mb 4.00mb 08:50 11/20/06
Last edited by Joel Spitzer on 08 Jul 2010, 12:23, edited 2 times in total.
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JohnPolito
Joined: 11 Nov 2008, 19:22

08 Jul 2010, 12:34 #7

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This link is to Joel's free e-book Never Take Another Puff.   Most of  the lessons shared in the book apply with equal weight to any chemical dependency, including alcohol.  If you have co-dependency concerns you are totally free within your mind to apply each lesson to the other drug or drugs as well, and to modify each article's Never Take Another Puff to include the means by which you administered the other drug.  

The next few minutes are all any of us can control and there was always only one rule ... none now, none today! 

Breathe deep, hug hard, live long,

John (Gold x11)    
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Joel Spitzer
Joined: 13 Nov 2008, 14:04

31 Dec 2012, 14:44 #8

With New Years upon us it is a good idea for recent quitters to be aware of drinking in regards to quitting and relapse prevention issues.
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JohnPolito
Joined: 11 Nov 2008, 19:22

04 May 2013, 15:08 #9

Neuronal nicotinic acetylcholine receptors: common molecular substrates of nicotine and alcohol dependence.

Front Psychiatry. 2013 Apr 30;4:29. doi: 10.3389/fpsyt.2013.00029. Print 2013.

Hendrickson LM, Guildford MJ, Tapper AR.
Source

Department of Psychiatry, Brudnick Neuropsychiatric Research Institute, University of Massachusetts Medical School Worcester, MA, USA.
Abstract

ImageAlcohol and nicotine are often co-abused. As many as 80-95% of alcoholics are also smokers, suggesting that ethanol and nicotine, the primary addictive component of tobacco smoke, may functionally interact in the central nervous system and/or share a common mechanism of action.

While nicotine initiates dependence by binding to and activating neuronal nicotinic acetylcholine receptors (nAChRs), ligand-gated cation channels normally activated by endogenous acetylcholine (ACh), ethanol is much less specific with the ability to modulate multiple gene products including those encoding voltage-gated ion channels, and excitatory/inhibitory neurotransmitter receptors.

However, emerging data indicate that ethanol interacts with nAChRs, both directly and indirectly, in the mesocorticolimbic dopaminergic (DAergic) reward circuitry to affect brain reward systems. Like nicotine, ethanol activates DAergic neurons of the ventral tegmental area (VTA) which project to the nucleus accumbens (NAc). Blockade of VTA nAChRs reduces ethanol-mediated activation of DAergic neurons, NAc DA release, consumption, and operant responding for ethanol in rodents. Thus, ethanol may increase ACh release into the VTA driving activation of DAergic neurons through nAChRs. In addition, ethanol potentiates distinct nAChR subtype responses to ACh and nicotine in vitro and in DAergic neurons. The smoking cessation therapeutic and nAChR partial agonist, varenicline, reduces alcohol consumption in heavy drinking smokers and rodent models of alcohol consumption. Finally, single nucleotide polymorphisms in nAChR subunit genes are associated with alcohol dependence phenotypes and smoking behaviors in human populations.

Together, results from pre-clinical, clinical, and genetic studies indicate that nAChRs may have an inherent role in the abusive properties of ethanol, as well as in nicotine and alcohol co-dependence.


PMID:  23641218
PubMed Link: http://www.ncbi.nlm.nih.gov/pubmed/23641218
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