Download PDF
Fortschr Neurol Psychiatr 2008; 76(1): 14-18
DOI: 10.1055/s-2007-980076
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Nikotinabhängigkeit als komorbide Störung bei Alkoholabhängigkeit - Epidemiologie, Ätiologie und Therapie

Nicotine Dependence as Comorbidity of Alcohol Dependence - Epidemiology, Etiology and TherapyA.  Diehl1 , N.  Scherbaum2
  • 1Zentralinstitut für Seelische Gesundheit - Klinik für Abhängiges Verhalten und Suchtmedizin (Prof. Dr. K. Mann)
  • 2Klinik für abhängiges Verhalten und Suchtmedizin, Rheinische Kliniken Essen, Kliniken der Universität Duisburg-Essen (Prof. Dr. N. Scherbaum)
Further Information

Publication History

Publication Date:
03 July 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Alkohol- und Nikotinabhängigkeit sind hoch miteinander assoziiert. Bei dieser zweifachen Abhängigkeit ist die Intensität der jeweiligen einzelnen Abhängigkeit hoch und der Verlauf ungünstiger als bei isolierter Abhängigkeit. Dies betrifft auch die Folgen der Abhängigkeiten für die körperliche Gesundheit und die kognitive Funktionstüchtigkeit. Mögliche biologische Ursachen dieser häufigen Komorbidität sind die additive belohnende Wirkung der Substanzen bei gemeinsamem Konsum, pharmakologische Interaktionen der Substanzen mit Einfluss auf Rezeptoraktivierung und Metabolisation mit Kompensation unangenehmer Alkoholnebenwirkungen durch Nikotinkonsum sowie eine gemeinsame genetische Disposition für beide Abhängigkeiten. Aus psychologischer Perspektive handelt es sich bei der Assoziation der beiden Konsumhandlungen um ein erlerntes Verhalten. Die Befürchtung, nikotinabhängige Alkoholabhängige seien an einer Nikotinentwöhnung nicht interessiert und ohnehin von einer Behandlung beider Abhängigkeiten generell überfordert, ist nicht empirisch gesichert. Allerdings sind die Erfolgsraten einer Nikotinentwöhnung bei dieser Gruppe geringer als bei Nikotinabhängigen ohne Alkoholprobleme. Bei den entsprechenden Untersuchungen wurden allerdings die üblichen therapeutischen Strategien zur Nikotinentwöhnung angewendet. Speziell auf Patienten mit Doppelabhängigkeit zugeschnittene Strategien sind wünschenswert.

Abstract

There is a high association between alcohol and nicotine dependence. Compared to one particular dependence, associated nicotine and alcohol dependence are more severe and the course is more unfavourable for each dependence. This also applies to the sequels of dependence regarding physical health and cognitive functions. Possible biological causes for this high comorbidity are 1) an additive rewarding effect by combined consumption, 2) substance interaction with an impact on receptor activation and metabolism which results in reduction of adverse acute alcohol effects, and 3) a combined genetic disposition for both addictions. From a psychological point of view the association of both acts of use is learned. There is no evidence for the commonly presumed fundamental lack of interest, motivation, and ability for smoking cessation in alcohol dependent patients. The outcome of smoking cessation programs, however, is less successful compared to smokers without alcohol problems. Respective studies have used the common therapeutic strategies for nicotine addiction. Specifically adapted strategies for patients with a dual dependence are required.

Schlüsselwörter

Nikotinabhängigkeit - Alkoholabhängigkeit - Therapie - Komorbidität - Ätiologie

Key words

Nicotine dependence - alcohol dependence - therapy - comorbidity - aetiology

Literatur

  • 1 Peto R, Lopez A D, Boreham J, Thun M, Heath Jr C. Mortality from tobacco in developed countries: indirect estimation from national vital statistics.  Lancet. 1992;  339 1268-1278
    Google Scholar
  • 2 WHO .The World Health Report 2002. Reducing Risks, Promoting Health Life. Geneva: WHO, World Health Organisation 2003
    Google Scholar
  • 3 Peto R, Lopez A D, Boreham J, Thun M, Heath Jr C, Doll R. Mortality from smoking worldwide.  Br Med Bull. 1996;  52 12-21
    Google Scholar
  • 4 Hughes J R. Treatment of nicotine dependence. Is more better?.  JAMA. 1995;  274 1390-1391
    Google Scholar
  • 5 Bien T H, Burge R. Smoking and drinking: a review of the literature.  Int J Addict. 1990;  25 1429-1454
    Google Scholar
  • 6 DiFranza J R, Guerrera M P. Alcoholism and smoking.  J Stud Alcohol. 1990;  51 130-135
    Google Scholar
  • 7 Gulliver S B, Rohsenow D J, Colby S M, Dey A N, Abrams D B, Niaura R S, Monti P M. Interrelationship of smoking and alcohol dependence, use and urges to use.  J Stud Alcohol. 1995;  56 202-206
    Google Scholar
  • 8 Johnson K A, Jennison K M. The drinking-smoking syndrome and social context.  Int J Addict. 1992;  27 749-792
    Google Scholar
  • 9 Grant B F, Hasin D S, Chou S P, Stinson F S, Dawson D A. Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions.  Arch Gen Psychiatry. 2004;  61 1107-1115
    Google Scholar
  • 10 Leonard S, Adler L E, Benhammou K, Berger R, Breese C R, Drebing C, Gault J, Lee M J, Logel J, Olincy A, Ross R G, Stevens K, Sullivan B, Vianzon R, Virnich D E, Waldo M, Walton K, Freedman R. Smoking and mental illness.  Pharmacol Biochem Behav. 2001;  70 561-570
    Google Scholar
  • 11 Hurt R D, Patten C A. Treatment of tobacco dependence in alcoholics.  Recent Dev Alcohol. 2003;  16 335-359
    Google Scholar
  • 12 Pomerleau C S. Co-factors for smoking and evolutionary psychobiology.  Addiction. 1997;  92 397-408
    Google Scholar
  • 13 Romberger D J, Grant K. Alcohol consumption and smoking status: the role of smoking cessation.  Biomed Pharmacother. 2004;  58 77-83
    Google Scholar
  • 14 Batel P, Pessione F, Maitre C, Rueff B. Relationship between alcohol and tobacco dependencies among alcoholics who smoke.  Addiction. 1995;  90 977-980
    Google Scholar
  • 15 John U, Meyer C, Rumpf H J, Hapke U. Probabilities of alcohol high-risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence.  Addiction. 2003;  98 805-814
    Google Scholar
  • 16 York J L, Hirsch J A. Drinking patterns and health status in smoking and nonsmoking alcoholics.  Alcohol Clin Exp Res. 1995;  19 666-673
    Google Scholar
  • 17 Daeppen J B, Smith T L, Danko G P, Gordon L, Landi N A, Nurnberger Jr J I, Bucholz K K, Raimo E, Schuckit M A. Clinical correlates of cigarette smoking and nicotine dependence in alcohol-dependent men and women. The Collaborative Study Group on the Genetics of Alcoholism.  Alcohol Alcohol. 2000;  35 171-175
    Google Scholar
  • 18 Toneatto A, Sobell L C, Sobell M B, Kozlowski L T. Effect of cigarette smoking on alcohol treatment outcome.  J Subst Abuse. 1995;  7 245-252
    Google Scholar
  • 19 Hertling I, Ramskogler K, Dvorak A, Klingler A, Saletu-Zyhlarz G, Schoberberger R, Walter H, Kunze M, Lesch O M. Craving and other characteristics of the comorbidity of alcohol and nicotine dependence.  Eur Psychiatry. 2005;  20 442-450
    Google Scholar
  • 20 Marks J L, Hill E M, Pomerleau C S, Mudd S A, Blow F C. Nicotine dependence and withdrawal in alcoholic and nonalcoholic ever-smokers.  J Subst Abuse Treat. 1997;  14 521-527
    Google Scholar
  • 21 Hughes J R. Clinical implications of the association between smoking and alcoholism. In: Fertig J, Fuller R, eds (Hrsg.). Alcohol and Tobacco: From Basic Science to Policy. Rockville, MD: National Institute on Alcoholism and Alcohol Abuse 1996: 171-185
    Google Scholar
  • 22 Currie S R, Hodgins D C, Guebaly N El, Campbell W. Influence of depression and gender on smoking expectancies and temptations in alcoholics in early recovery.  J Subst Abuse. 2001;  13 443-458
    Google Scholar
  • 23 Hurt R D, Offord K P, Croghan I T, Gomez-Dahl L, Kottke T E, Morse R M, Melton III L J. Mortality following inpatient addictions treatment. Role of tobacco use in a community-based cohort.  JAMA. 1996;  275 1097-1103
    Google Scholar
  • 24 Miller N S, Gold M S. Comorbid cigarette and alcohol addiction: epidemiology and treatment.  J Addict Dis. 1998;  17 55-66
    Google Scholar
  • 25 Peto R, Lopez A D, Boreham J, Thun M, Heath Jr C, Doll R. Mortality from smoking worldwide.  Br Med Bull. 1996;  52 12-21
    Google Scholar
  • 26 Vaillant G E, Schnurr P P, Baron J A, Gerber P D. A prospective study of the effects of cigarette smoking and alcohol abuse on mortality.  J Gen Intern Med. 1991;  6 299-304
    Google Scholar
  • 27 Blot W J, McLaughlin J K, Winn D M, Austin D F, Greenberg R S, Preston-Martin S, Bernstein L, Schoenberg J B, Stemhagen A, Fraumeni Jr J F. Smoking and drinking in relation to oral and pharyngeal cancer.  Cancer Res. 1988;  48 3282-3287
    Google Scholar
  • 28 Hawkins B T, Brown R C, Davis T P. Smoking and ischemic stroke: a role for nicotine?.  Trends Pharmacol Sci. 2002;  23 78-82
    Google Scholar
  • 29 Bolego C, Poli A, Paoletti R. Smoking and gender.  Cardiovasc Res. 2002;  53 568-576
    Google Scholar
  • 30 Meyerhoff D J, Tizabi Y, Staley J K, Durazzo T C, Glass J M, Nixon S J. Smoking comorbidity in alcoholism: neurobiological and neurocognitive consequences.  Alcohol Clin Exp Res. 2006;  30 253-264
    Google Scholar
  • 31 Brody A L, Mandelkern M A, Jarvik M E, Lee G S, Smith E C, Huang J C, Bota R G, Bartzokis G, London E D. Differences between smokers and nonsmokers in regional gray matter volumes and densities.  Biol Psychiatry. 2004;  55 77-84
    Google Scholar
  • 32 Hayee A, Haque A, Anwarullah A K, Rabbani M G. Smoking enhances age related brain atrophy - a quantitative study with computed tomography.  Bangladesh Med Res Counc Bull. 2003;  29 118-124
    Google Scholar
  • 33 Durazzo T C, Gazdzinski S, Banys P, Meyerhoff D J. Cigarette smoking exacerbates chronic alcohol-induced brain damage: a preliminary metabolite imaging study.  Alcohol Clin Exp Res. 2004;  28 1849-1860
    Google Scholar
  • 34 Gazdzinski S, Durazzo T C, Studholme C, Song E, Banys P, Meyerhoff D J. Quantitative brain MRI in alcohol dependence: preliminary evidence for effects of concurrent chronic cigarette smoking on regional brain volumes.  Alcohol Clin Exp Res. 2005;  29 1484-1495
    Google Scholar
  • 35 Durazzo T C, Gazdzinski S, Rothlind J C, Banys P, Meyerhoff D J. Brain metabolite concentrations and neurocognition during short-term recovery from alcohol dependence: Preliminary evidence of the effects of concurrent chronic cigarette smoking.  Alcohol Clin Exp Res. 2006;  30 539-551
    Google Scholar
  • 36 Ceballos N A, Tivis R, Lawton-Craddock A, Nixond S J. Nicotine and cognitive efficiency in alcoholics and illicit stimulant abusers: implications of smoking cessation for substance users in treatment.  Subst Use Misuse. 2006;  41 265-281
    Google Scholar
  • 37 Ernst M, Heishman S J, Spurgeon L, London E D. Smoking history and nicotine effects on cognitive performance.  Neuropsychopharmacology. 2001;  25 313-319
    Google Scholar
  • 38 Hill R D. Residual effects of cigarette smoking on cognitive performance in normal aging.  Psychol Aging. 1989;  4 251-254
    Google Scholar
  • 39 Kalmijn S, Boxtel M P van, Verschuren M W, Jolles J, Launer L J. Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age.  Am J Epidemiol. 2002;  156 936-944
    Google Scholar
  • 40 Glass J M, Adams K M, Nigg J T, Wong M M, Puttler L I, Buu A, Jester J M, Fitzgerald H E, Zucker R A. Smoking is associated with neurocognitive deficits in alcoholism.  Drug Alcohol Depend. 2006;  82 119-126
    Google Scholar
  • 41 Pierce R C, Kumaresan V. The mesolimbic dopamine system: the final common pathway for the reinforcing effect of drugs of abuse?.  Neurosci Biobehav Rev. 2006;  30 215-238
    Google Scholar
  • 42 Balfour D J. The neurobiology of tobacco dependence: a preclinical perspective on the role of the dopamine projections to the nucleus.  Nicotine Tob Res. 2004;  6 899-912
    Google Scholar
  • 43 Balfour D J, Wright A E, Benwell M E, Birrell C E. The putative role of extra-synaptic mesolimbic dopamine in the neurobiology of nicotine dependence.  Behav Brain Res. 2000;  113 73-83
    Google Scholar
  • 44 Koob G F, Roberts A J, Schulteis G, Parsons L H, Heyser C J, Hyytia P, Merlo-Pich E, Weiss F. Neurocircuitry targets in ethanol reward and dependence.  Alcohol Clin Exp Res. 1998;  22 3-9
    Google Scholar
  • 45 Phillips T J, Shen E H. Neurochemical bases of locomotion and ethanol stimulant effects.  Int Rev Neurobiol. 1996;  39 243-282
    Google Scholar
  • 46 Tizabi Y, Copeland Jr R L, Louis V A, Taylor R E. Effects of combined systemic alcohol and central nicotine administration into ventral tegmental area on dopamine release in the nucleus accumbens.  Alcohol Clin Exp Res. 2002;  26 394-399
    Google Scholar
  • 47 Ericson M, Blomqvist O, Engel J A, Soderpalm B. Voluntary ethanol intake in the rat and the associated accumbal dopamine overflow are blocked by ventral tegmental mecamylamine.  Eur J Pharmacol. 1998;  358 189-196
    Google Scholar
  • 48 Blomqvist O, Hernandez-Avila C A, Kirk J Van, Rose J E, Kranzler H R. Mecamylamine modifies the pharmacokinetics and reinforcing effects of alcohol.  Alcohol Clin Exp Res. 2002;  26 326-331
    Google Scholar
  • 49 Young E M, Mahler S, Chi H, Wit H de. Mecamylamine and ethanol preference in healthy volunteers.  Alcohol Clin Exp Res. 2005;  29 58-65
    Google Scholar
  • 50 Soderpalm B, Ericson M, Olausson P, Blomqvist O, Engel J A. Nicotinic mechanisms involved in the dopamine activating and reinforcing properties of ethanol.  Behav Brain Res. 2000;  113 85-96
    Google Scholar
  • 51 Rose J E, Brauer L H, Behm F M, Cramblett M, Calkins K, Lawhon D. Potentiation of nicotine reward by alcohol.  Alcohol Clin Exp Res. 2002;  26 1930-1931
    Google Scholar
  • 52 Hughes J R, Rose G L, Callas P W. Nicotine is more reinforcing in smokers with a past history of alcoholism than in smokers without this history.  Alcohol Clin Exp Res. 2000;  24 1633-1638
    Google Scholar
  • 53 Campbell V C, Taylor R E, Tizabi Y. Antinociceptive effects of alcohol and nicotine: involvement of the opioid system.  Brain Res. 2006;  1097 71-77
    Google Scholar
  • 54 Howard L A, Ahluwalia J S, Lin S K, Sellers E M, Tyndale R F. CYP2E1*1D regulatory polymorphism: association with alcohol and nicotine dependence.  Pharmacogenetics. 2003;  13 321-328
    Google Scholar
  • 55 Howard L A, Miksys S, Hoffmann E, Mash D, Tyndale R F. Brain CYP2E1 is induced by nicotine and ethanol in rat and is higher in smokers and alcoholics.  Br J Pharmacol. 2003;  138 1376-1386
    Google Scholar
  • 56 Narahashi T, Soderpalm B, Ericson M, Olausson P, Engel J A, Zhang X, Nordberg A, Marszalec W, Aistrup G L, Schmidt L G, Kalouti U, Smolka A M, Hedlund L. Mechanisms of alcohol-nicotine interactions: alcoholics versus smokers.  Alcohol Clin Exp Res. 2001;  25 152S-156S
    Google Scholar
  • 57 Larsson A, Engel J A. Neurochemical and behavioral studies on ethanol and nicotine interactions.  Neurosci Biobehav Rev. 2004;  27 713-720
    Google Scholar
  • 58 Tizabi Y, Manaye K F, Smoot D T, Taylor R E. Nicotine inhibits ethanol-induced toxicity in cultured cerebral cortical cells.  Neurotox Res. 2004;  6 311-316
    Google Scholar
  • 59 Tizabi Y, Manaye K F, Taylor R E. Nicotine blocks ethanol-induced apoptosis in primary cultures of rat cerebral cortical and cerebellar granule cells.  Neurotox Res. 2005;  7 319-322
    Google Scholar
  • 60 Collins A C, Wilkins L H, Slobe B S, Cao J Z, Bullock A E. Long-term ethanol and nicotine treatment elicit tolerance to ethanol.  Alcohol Clin Exp Res. 1996;  20 990-999
    Google Scholar
  • 61 Howard L A, Ahluwalia J S, Lin S K, Sellers E M, Tyndale R F. CYP2E1*1D regulatory polymorphism: association with alcohol and nicotine dependence.  Pharmacogenetics. 2003;  13 321-328
    Google Scholar
  • 62 Lopez M F, White N M, Randall C L. Alcohol tolerance and nicotine cross-tolerance in adolescent mice.  Addict Biol. 2001;  6 119-127
    Google Scholar
  • 63 Madden P A, Heath A C, Starmer G A, Whitfield J B, Martin N G. Alcohol sensitivity and smoking history in men and women.  Alcohol Clin Exp Res. 1995;  19 1111-1120
    Google Scholar
  • 64 Dar M S, Bowman E R, Li C. Intracerebellar nicotinic-cholinergic participation in the cerebellar adenosinergic modulation of ethanol-induced motor incoordination in mice.  Brain Res. 1994;  644 117-127
    Google Scholar
  • 65 Staley J K, Gottschalk C, Petrakis I L, Gueorguieva R, O'Malley S, Baldwin R, Jatlow P, Verhoeff N P, Perry E, Weinzimmer D, Frohlich E, Ruff E, Dyck C H van, Seibyl J P, Innis R B, Krystal J H. Cortical gamma-aminobutyric acid type A-benzodiazepine receptors in recovery from alcohol dependence: relationship to features of alcohol dependence and cigarette smoking.  Arch Gen Psychiatry. 2005;  62 877-888
    Google Scholar
  • 66 Howard L A, Ahluwalia J S, Lin S K, Sellers E M, Tyndale R F. CYP2E1*1D regulatory polymorphism: association with alcohol and nicotine dependence.  Pharmacogenetics. 2003;  13 321-328
    Google Scholar
  • 67 Howard L A, Miksys S, Hoffmann E, Mash D, Tyndale R F. Brain CYP2E1 is induced by nicotine and ethanol in rat and is higher in smokers and alcoholics.  Br J Pharmacol. 2003;  138 1376-1386
    Google Scholar
  • 68 Dani J A, Harris R A. Nicotine addiction and comorbidity with alcohol abuse and mental illness.  Nat Neurosci. 2005;  8 1465-1470
    Google Scholar
  • 69 Li X C, Karadsheh M S, Jenkins P M, Stitzel J A. Genetic correlation between the free-choice oral consumption of nicotine and alcohol in C57BL/6JxC3H/HeJ F2 intercross mice.  Behav Brain Res. 2005;  157 79-90
    Google Scholar
  • 70 True W R, Xian H, Scherrer J F, Madden P A, Bucholz K K, Heath A C, Eisen S A, Lyons M J, Goldberg J, Tsuang M. Common genetic vulnerability for nicotine and alcohol dependence in men.  Arch Gen Psychiatry. 1999;  56 655-661
    Google Scholar
  • 71 Madden P A, Heath A C. Shared genetic vulnerability in alcohol and cigarette use and dependence.  Alcohol Clin Exp Res. 2002;  26 1919-1921
    Google Scholar
  • 72 Palfai T P, Monti P M, Ostafin B, Hutchison K. Effects of nicotine deprivation on alcohol-related information processing and drinking behaviour.  J Abnrom Psychol. 2000 Feb;  109 (1) 96-105
    Google Scholar
  • 73 Colby S M, Rohsenow D J, Monti P M, Gwaltney C J, Gulliver S B, Abrams D B, Niaura R S, Siroa A D. Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults.  Addict Behav. 2004 Jul;  29 (5) 879-892
    Google Scholar
  • 74 Cooney J L, Cooney N L, Pilkey D T, Kranzler H R, Oncken C A. Effects of nicotine deprivation on urges to drink and smoke in alcoholic smokers.  Addiction. 2003 Jul;  98 (7) 913-921
    Google Scholar
  • 75 DiFranza J R, Guerrera M P. Alcoholism and smoking.  J Stud Alcohol. 1990;  51 130-135
    Google Scholar
  • 76 Hertling I, Ramskogler K, Dvorak A, Klingler A, Saletu-Zyhlarz G, Schoberberger R, Walter H, Kunze M, Lesch O M. Craving and other characteristics of the comorbidity of alcohol and nicotine dependence.  Eur Psychiatry. 2005;  20 442-450
    Google Scholar
  • 77 Covey L S, Glassman A H, Stetner F, Becker J. Effect of history of alcoholism or major depression on smoking cessation.  Am J Psychiatry. 1993;  150 1546-1547
    Google Scholar
  • 78 Abrams D B, Niaura R, Brown R A, Emmons K M, Goldstein M G, Monti P M. The Tobacco Dependence Treatment Handbook. A Guide To Best Practices. New York: The Guiford Press 2003
    Google Scholar
  • 79 Hurt R D. Pharmacotherapy for alcoholic smokers.  Alcohol Clin Exp Res. 2002;  26 1939-1941
    Google Scholar
  • 80 Hughes J R, Kalman D. Do smokers with alcohol problems have more difficulty quitting?.  Drug Alcohol Depend. 2006;  82 91-102
    Google Scholar
  • 81 Bowman J A, Walsh R A. Smoking intervention within alcohol and other drug treatment services: a selective review with suggestions for practical management.  Drug Alcohol Rev. 2003;  22 73-82
    Google Scholar
  • 82 Sussman S. Smoking cessation among persons in recovery.  Subst Use Misuse. 2002;  37 1275-1298
    Google Scholar
  • 83 Bobo J K, Gilchrist L D. Urging the alcoholic client to quit smoking cigarettes.  Addictive Behaviors. 1983;  8 297-305
    Google Scholar
  • 84 Gulliver S B, Rohsenow D J, Colby S M, Dey A N, Abrams D B, Niaura R S, Monti P M. Interrelationship of smoking and alcohol dependence, use and urges to use.  J Stud Alcohol. 1995;  56 202-206
    Google Scholar
  • 85 Colby S M, Rohsenow D J, Monti P M, Gwaltney C J, Gulliver S B, Abrams D B, Niaura R S, Sirota A D. Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults.  Addict Behav. 2004;  29 879-892
    Google Scholar
  • 86 Joseph A, Lexau B, Willenbring M, Nugent S, Nelson D. Factors associated with readiness to stop smoking among patients in treatment for alcohol use disorder.  Am J Addict. 2004;  13 405-417
    Google Scholar
  • 87 Kandel D, Chen K, Warner L A, Kessler R C, Grant B. Prevalence and demographic correlates of symptoms of last year dependence on alcohol, nicotine, marijuana and cocaine in the U.S. population.  Drug Alcohol Depend. 1997;  44 11-29
    Google Scholar
  • 88 Bobo J K, McIlvain H E, Gilchrist L D, Bowman A. Nicotine dependence and intentions to quit smoking in three samples of male and female recovering alcoholics and problem drinkers.  Subst Use Misuse. 1996;  31 17-33
    Google Scholar
  • 89 Ellingstad T P, Sobell L C, Sobell M B, Cleland P A, Agrawal S. Alcohol abusers who want to quit smoking: implications for clinical treatment.  Drug Alcohol Depend. 1999;  54 259-265
    Google Scholar
  • 90 Sobell M B, Sobell L C, Kozlowski L T. Dual recoveries from alcohol and smoking problems. In: Fertig JB, Allen JP, eds (Hrsg.). Alcohol and Tobacco: From basic Science to Clinical Practice. Bethesda, M.D.: National Institutes of Health 1995: 207-224
    Google Scholar
  • 91 Hurt R D, Eberman K M, Croghan I T, Offord K P, Davis Jr L J, Morse R M, Palmen M A, Bruce B K. Nicotine dependence treatment during inpatient treatment for other addictions: a prospective intervention trial.  Alcohol Clin Exp Res. 1994;  18 867-872
    Google Scholar
  • 92 Bobo J K, McIlvain H E, Lando H A, Walker R D, Leed-Kelly A. Effect of smoking cessation counseling on recovery from alcoholism: findings from a randomized community intervention trial.  Addiction. 1998;  93 877-887
    Google Scholar
  • 93 Friend K B, Pagano M E. Changes in cigarette consumption and drinking outcomes: findings from Project MATCH.  J Subst Abuse Treat. 2005;  29 221-229
    Google Scholar
  • 94 Hughes J R, Callas P W. Past alcohol problems do not predict worse smoking cessation outcomes.  Drug Alcohol Depend. 2003;  71 269-273
    Google Scholar
  • 95 Hughes J R, Kalman D. Do smokers with alcohol problems have more difficulty quitting?.  Drug Alcohol Depend. 2006;  82 91-102
    Google Scholar
  • 96 Olbrich R, Troeger S, Nikitopoulos J, Mann K, Diehl A. Successful smoking reduction during inpatient alcohol detoxification: a controlled clinical trial.  European Archives of Psychiatry and Clinical Neurosciences submitted. 2007; 
    Google Scholar
  • 97 Fiore M C, Bailey W C, Cohen S J, Dorfman S F, Goldstein M G, Gritz E R, Heyman R B, Jaen C R, Kottke T E, Lando H A, Mecklenburg R E, Mullen P D, Nett L M, Robinson L, Stitzer M L, Tommasello A C, Villejo L, Wewers M E. Treating Tobacco Use and Dependence. Clinical Practice Guideline. U.S. Department of Health and Human Services, Public Health Service 2000
    Google Scholar
  • 98 Kalman D, Hayes K, Colby S M, Eaton C A, Rohsenow D J, Monti P M. Concurrent versus delayed smoking cessation treatment for persons in early alcohol recovery. A pilot study.  J Subst Abuse Treat. 2001;  20 233-238
    Google Scholar
  • 99 Saxon A J, Baer J S, Davis T M, Sloan K L, Malte C A, Fitzgibbons K, Kivlahan D R. Smoking cessation treatment among dually diagnosed individuals: preliminary evaluation of different pharmacotherapies.  Nicotine Tob Res. 2003;  5 589-596
    Google Scholar
  • 100 Hughes J R, Novy P, Hatsukami D K, Jensen J, Callas P W. Efficacy of nicotine patch in smokers with a history of alcoholism.  Alcohol Clin Exp Res. 2003;  27 946-954
    Google Scholar
  • 101 Hurt R D, Dale L C, Offord K P, Croghan I T, Hays J T, Gomez-Dahl L. Nicotine patch therapy for smoking cessation in recovering alcoholics.  Addiction. 1995;  90 1541-1546
    Google Scholar
  • 102 Hurt R D, Dale L C, Offord K P, Croghan I T, Hays J T, Gomez-Dahl L. Nicotine patch therapy for smoking cessation in recovering alcoholics.  Addiction. 1995;  90 1541-1546
    Google Scholar
  • 103 Hurt R D. Pharmacotherapy for alcoholic smokers.  Alcohol Clin Exp Res. 2002;  26 1939-1941
    Google Scholar
  • 104 Ascher J A, Cole J O, Colin J N, Feighner J P, Ferris R M, Fibiger H C, Golden R N, Martin P, Potter W Z, Richelson E. Bupropion: a review of its mechanism of antidepressant activity.  J Clin Psychiatry. 1995;  56 395-401
    Google Scholar
  • 105 Slemmer J E, Martin B R, Damaj M I. Bupropion is a nicotinic antagonist.  J Pharmacol Exp Ther. 2000;  295 321-327
    Google Scholar
  • 106 Fryer J D, Lukas R J. Noncompetitive functional inhibition at diverse, human nicotinic acetylcholine receptor subtypes by bupropion, phencyclidine, and ibogaine.  J Pharmacol Exp Ther. 1999;  288 88-92
    Google Scholar
  • 107 Hayford K E, Patten C A, Rummans T A, Schroeder D R, Offord K P, Croghan I T, Glover E D, Sachs D P, Hurt R D. Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism.  Br J Psychiatry. 1999;  174 173-178
    Google Scholar
  • 108 Jorenby D E, Leischow S J, Nides M A, Rennard S I, Johnston J A, Hughes A R, Smith S S, Muramoto M L, Daughton D M, Doan K, Fiore M C, Baker T B. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation.  N Engl J Med. 1999;  340 685-691
    Google Scholar
  • 109 Hays J T, Hurt R D, Rigotti N A, Niaura R, Gonzales D, Durcan M J, Sachs D P, Wolter T D, Buist A S, Johnston J A, White J D. Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation. a randomized, controlled trial.  Ann Intern Med. 2001;  135 423-433
    Google Scholar
  • 110 Johnson B A. Uses of topiramate in the treatment of alcohol dependence.  Expert Rev Neurother. 2004;  4 751-758
    Google Scholar
  • 111 Cohen C, Kodas E, Griebel G. CB1 receptor antagonists for the treatment of nicotine addiction.  Pharmacol Biochem Behav. 2005;  81 387-395
    Google Scholar
  • 112 Diehl A, Nakovics H, Croissant B, Smolka M N, Batra A, Mann K. Galantamine reduces smoking in alcohol-dependent patients: a randomized, placebo-controlled trial.  Int J Clin Pharmacol Ther. 2006;  44 614-622
    Google Scholar
  • 113 Byars J A, Frost-Pineda K, Jacobs W S, Gold M S. Naltrexone Augments the Effects of Nicotine Replacement Therapy in Female Smokers.  J Addict Dis. 2005;  24 49-60
    Google Scholar
  • 114 Stead L F, Lancaster T. Group behaviour therapy programmes for smoking cessation.  Cochrane Database Syst Rev. 2005;  CD001007
    Google Scholar
  • 115 Bobo J K, McIlvain H E, Lando H A, Walker R D, Leed-Kelly A. Effect of smoking cessation counseling on recovery from alcoholism: findings from a randomized community intervention trial.  Addiction. 1998;  93 877-887
    Google Scholar
  • 116 Joseph A M, Nichol K L, Willenbring M L, Korn J E, Lysaght L S. Beneficial effects of treatment of nicotine dependence during an inpatient substance abuse treatment program.  JAMA. 1990;  263 3043-3046
    Google Scholar
  • 117 Burling T A, Marshall G D, Seidner A L. Smoking cessation for substance abuse inpatients.  J Subst Abuse. 1991;  3 269-276
    Google Scholar
  • 118 Miller W R, Rollnick S. Motivational Interviewing: Preparing people to change addictive behaviour. New York: Guilford Press 1991
    Google Scholar
  • 119 Rohsenow D J, Monti P M, Colby S M, Martin R A. Brief interventions for smoking cessation in alcoholic smokers.  Alcohol Clin Exp Res. 2002;  26 1950-1951
    Google Scholar
  • 120 Martin J E, Calfas K J, Patten C A, Polarek M, Hofstetter C R, Noto J, Beach D. Prospective evaluation of three smoking interventions in 205 recovering alcoholics: one-year results of Project SCRAP-Tobacco.  J Consult Clin Psychol. 1997;  65 190-194
    Google Scholar
  • 121 Murray R P, Cribbie R A, Istvan J A, Barnes G E. Longitudinal analysis of the relationship between changes in smoking and changes in drinking in a community sample: the Winnipeg Health and Drinking Survey.  Health Psychol. 2002;  21 237-243
    Google Scholar
  • 122 McIlvain H E, Bobo J K, Leed-Kelly A, Sitorius M A. Practical steps to smoking cessation for recovering alcoholics.  Am Fam Physician. 1998;  57 1869-1882
    Google Scholar
  • 123 Romberger D J, Grant K. Alcohol consumption and smoking status: the role of smoking cessation.  Biomed Pharmacother. 2004;  58 77-83
    Google Scholar
  • 124 Jimenez-Ruiz C, Solano S, Viteri S A, Ferrero M B, Torrecilla M, Mezquita M H. Harm reduction - a treatment approach for resistant smokers with tobacco-related symptoms.  Respiration. 2002;  69 452-455
    Google Scholar
  • 125 Wennike P, Danielsson T, Landfeldt B, Westin A, Tonnesen P. Smoking reduction promotes smoking cessation: results from a double blind, randomized, placebo-controlled trial of nicotine gum with 2-year follow-up.  Addiction. 2003;  98 1395-1402
    Google Scholar
  • 126 Batra A, Klingler K, Landfeldt B, Friederich H M, Westin A, Danielsson T. Smoking reduction treatment with 4-mg nicotine gum: a double-blind, randomized, placebo-controlled study.  Clin Pharmacol Ther. 2005;  78 689-696
    Google Scholar

Prof. Dr. med. Norbert ScherbaumDirektor der Klinik für Abhängiges Verhalten und Suchtmedizin, Komm. Direktor der Klinik für Psychiatrie und Psychotherapie

Rheinische Kliniken Essen, Kliniken der Universität Duisburg-Essen

Virchowstr. 174

45147 Essen

Email: norbert.scherbaum@uni-due.de