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
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
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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