Smoking Hotlines Can Flag Problem Drinking

By Charles Feng, M.D.

Hotlines to help people quit smoking could also flag problem drinking, a new study found.

Yale researchers used surveys to probe alcohol use among 88,479 callers to the New York State Smoker's Quitline and found nearly one-quarter of callers reported hazardous drinking as well.

"Once people start drinking, there is a trigger to start smoking," said study author Benjamin Toll, assistant professor of psychiatry at the Yale School of Medicine and director of Smilow Cancer Hospital at Yale-New Haven's Smoking Cessation Service. "They lose their inhibition to tobacco."

The study was published today in the journal Alcoholism: Clinical and Experimental Research.

Previous studies suggest alcohol abuse decreases the likelihood that smokers will quit using cigarettes, and that adding a brief alcohol intervention to standard smoking cessation treatments could improve success rates.

"The suggestion that tobacco quitlines may offer novel opportunities to reach alcoholics is rational, if not obvious," said Dr. Stephen Jay, a professor of medicine at the Indiana University School of Medicine in Indianapolis. However, he cautions, "the use of tobacco quitlines for purposes other than for which they were designed will need to be carefully studied."

A call to the smoking cessation quitline involves a 10- to 15-minute conversation in which smokers are asked about their past attempts to stop smoking, and counselors discuss methods that smokers can use to quit smoking.

"Someone identified as an unhealthy alcohol user should be referred to medical treatment for a comprehensive evaluation," said Dr. Edwin Salsitz, director of the Methadone Medical Maintenance Program at Beth Israel Medical Center in New York City. "There could be a very valuable role for quitlines… to help alcoholics, after they have been properly assessed."

Toll's next study will assess whether adding five minutes of alcohol abuse counseling to quitline conversations can boost smoking cessation rates.

"Our hope is that we can reduce smoking by getting people to drink less," Toll said.