Both tobacco and alcohol can be highly addictive and have long-ranging health consequences. The effects of mixing tobacco and alcohol can include a shortened life span, interpersonal problems, and respiratory problems. This is because both substances can be dangerous on their own and because tobacco is a mild stimulant, while alcohol is a depressant. Also, both tobacco and alcohol are legal and widely available, making them easier to abuse.
Tobacco and Alcohol Effects
Tobacco is a plant-based drug that contains nicotine, which is the addictive substance in cigarettes. Cigarettes contain much more than just nicotine, though. They also include tar, preservatives, and chemicals that are carcinogens, meaning that they cause cancer. Included among these chemicals are arsenic, cadmium, carbon monoxide, ammonia, butane, hydrogen cyanide, and DDT. When you smoke a cigarette, the nicotine constricts the blood vessels in your body, causing your blood pressure to become higher. High blood pressure is included with health problems such as strokes. Nicotine also increases your heart rate and stimulates the nervous system. Smoking a cigarette may cause a mild, temporary buzz.
Alcohol is a depressant, meaning it slows the functioning of the mind and the body. This is because it decreases the activity between the brain’s neurons, which control all of the body’s functions. Even a small amount of alcohol can cause side effects such as dizziness, giddiness, and sleepiness. Moderate drinking is defined by the Centers for Disease Control (CDC) as anything over one drink per day for women and adults over the age of 65 and more than two drinks per day for men under 65. Children and teenagers should never drink. Drinking more than a moderate quantity at one time can result in nausea, vomiting, trouble sleeping, and poor judgment. Accidents and falls are more likely to happen after the consumption of too much alcohol.
Tobacco and Alcohol – Hand in Hand
In tests on human volunteers, Duke University Medical Center researchers have found that even small amounts of alcohol boost the pleasurable effects of nicotine, inducing people to smoke more when drinking alcoholic beverages. The findings provide a physiological explanation for the common observation that people smoke more in bars. The findings also explain statistics showing that alcoholics tend to smoke more than non-alcoholics, and that smokers are more likely to be alcoholics.
The finding, published in the February/March 2004 issue of Nicotine and Tobacco Research, might help elucidate why those who have quit smoking often relapse while drinking alcohol. Such insights might lead to new smoking cessation methods that take the drugs' interaction into account, said Jed Rose, Ph.D., director of the Duke Nicotine Research Program and co-creator of the nicotine patch.
"Epidemiological, clinical, and laboratory evidence clearly indicate a behavioral link between cigarette smoking and alcohol use," Rose said. "The combined use of cigarettes and alcohol presents health risks over and above the risks posed by smoking alone, and thus constitutes a serious public health problem which deserves additional research attention. In particular, understanding the pharmacological basis of the interaction between alcohol and nicotine could lead to the development of effective strategies for treating the drugs' dual use."
Eighty to 90 percent of alcoholics smoke -- a rate three times that of the general population, he said. Moreover, the prevalence of alcoholism in smokers is 10 times higher than among nonsmokers.
One theory holds that nicotine offsets the sedative effects of alcohol. For example, studies have reported that nicotine counteracts the decline in the performance of certain visual tasks and the slowed reaction time induced by alcohol. Alternatively, using nicotine and alcohol in concert might serve to increase the feeling of pleasure associated with either drug alone. Both drugs have been shown to boost brain concentrations of dopamine -- a nerve cell messenger implicated in the positive reinforcement underlying addiction.
Neurobiological studies have yielded further conflicting evidence. Some have reported that ethanol increases the activity of the brain receptors that respond to nicotine, while others have indicated a dampened response of certain subtypes of the so-called nicotinic receptors in the presence of ethanol.
The Duke team recruited 48 regular smokers who normally drank at least four alcoholic beverages weekly. The researchers served each participant either alcoholic or placebo beverages. In one such session, individuals were provided regular cigarettes, while in another they were provided nicotine-free cigarettes as a control.
According to the participants' own ratings, ethanol enhanced many of the rewarding effects of nicotine, including satisfaction and the drug's calming effects, compared to placebo beverages. Smoking nicotine-free cigarettes did not elicit the same positive response from those receiving alcohol, the team found, indicating that nicotine itself, rather than other aspects of smoking, was the critical ingredient underlying the interaction.
"A relatively low dose of alcohol -- below that required to induce any measurable euphoria -- was enough to increase participants' enjoyment of nicotine significantly," Rose said. "In light of the current finding, it makes sense that so many people who have quit smoking relapse when they drink."
Tobacco and Alcohol – Dangerous Mix
Because of this interaction between tobacco and alcohol, the person who both smoke and drinks heavily may be greater risk of becoming ill than one who “drinks like a fish” but never smokes, or one who ” smokes like a chimney” but never drinks. Dr. Albert J. Tuyns and his colleagues at the International Agency for Research on Cancer in Lyon, France, found that the risk of esophagus cancer was 18 times higher for someone who smoked moderately and drank heavily increased the risk 44 times.
After reviewing scientific studies that reached similar findings about different types of alcoholic beverages and cancers, including those of the mouth, pharynx and larynx, the U.S National Institute on Alcohol Abuse and Alcohol stated: “Alcohol has a synergistic effect with tobacco that the risk of cancer.”
To get an idea of how this synergism may work, consider what happens when a smoker lights up a cigarette. With each puff inhales at least 400 different chemicals – all of which are known to cause cancer. Most chemical vapors in tobacco smoke get deposited in the mouth, nose, throat, and lungs in a coating of burned plant resins called tar.
Then, in a scenario typical of chronic heavy drinkers – most of whom also smoke – our smoker feels thirsty and washes down that smoke coating in his mouth and throat with whiskey. The alcohol in his drink may not in itself cause cancer, but it may act as solvent, dissolving the tar – trapped tobacco poisons, and easing the transport of carcinogens across membranes.
Our smoker continues to drink. Soon he lights another cigarette and inhales deeply. Behind his embattled lungs, meanwhile, his liver has gone on full alert to save his life. This three – pound “chemical factory,” which cleans most toxins from the blood – stream, reacts to alcohol as a foreign substance and metabolizes 95% of it into other chemicals. But in turning its energy to clearing just one-half ounce of pure alcohol – the liver’s other metabolic functions suffer a sharp decrease. Poisons from tobacco smoke that otherwise would be removed from his blood within minutes are not allowed to flood his body for hours or days, depending on how much alcohol the liver must dispose of.
While battling alcohol, the liver also puts aside another important function, clearing fat the bloodstream. An excess of fatty substances called lipids, and fat by – products, such as triglycerides, begin to clog the bloodstreams. At the same time, chemicals from cigarette smoke are increasing the coagulating tendency of the blood begins to clog capillaries, blood cells carrying food and oxygen struggle to reach each of the body’s cells.
Inside the lungs, molecules of oxygen attach to red blood cells containing the iron molecule hemoglobin. But the trouble is, with each puff from his cigarette our drinking smoker inhales carbon monoxide, blocking the ability of those red blood cells to carry oxygen. The person who smokes one or two packs of cigarettes a day loses an average 6 to 8% of his blood’s oxygen – carrying capacity.
The synergistic effects of alcohol and tobacco may deliver a powerful blow to the cardiovascular system as well as the upper respiratory tract. For those prone to hypertension who drink more than two ounces of alcohol a day, high blood pressure is common and with it the increased risk to stroke and heart attack. For the hypertensive who combine smoking and drinking, the risks are even greater. (However, researchers consistently find that non – smoking moderate drinkers – are less likely to suffer heart attack than are either abstainers or heavy drinkers.)
It is a particularly important for pregnant woman to be aware of the dangerous combined effects of tobacco and alcohol. When a pregnant woman smokes, a large portion of her blood’s oxygen – carrying capacity, which the fetus depends on - is taken over by inhaled carbon monoxide. Nicotine in the mother’s blood causes constriction of blood vessels, adding to the strain on oxygen delivery and decreasing the supply of nutrients to her baby.
If, after smoking, the expectant mother abuses alcohol, her risk of miscarriage is increased. Even moderate drinking increases the risk of lighter weight of newborns at birth exposing them to a wide range of diseases. Likewise, a number of studies underscore the role of excessive alcohol in structural abnormalities such as retardation in newborn babies. What’s more woman who smoke during pregnancy also increase the chance of miscarriage or infant death.
Men often begin drinking and smoking as adolescents because they perceive alcohol and tobacco use as symbol of manhood. But ironically, as scientists even moderate use of alcohol can delay sexual maturation. The reason is that testosterone, the key male sex hormone, is reduce in the blood – stream by chronic heavy drinking. The role of tobacco in the process is not as clear although several studies suggest that excessive smoking is a factor in irregularly shaped sperm cells. Thus, when a man becomes a heavy user of alcohol and tobacco, the abuse can affect his chances of fathering healthy babies later in life.
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