NASHVILLE, Tenn. Prescription nicotine patches, gum, and nasal sprays to help people quit smoking can also reduce their alcohol intake.
Originally designed as the control arm of a clinical trial testing whether prescription anti-smoking drugs would help people consume less alcohol, the study found that these common remedies worked just as well. After three months, the participants reduced their alcohol consumption regardless of whether they used nicotine replacement therapy or prescription medications, such as varenicline or cytisine.
The researchers say that all of these drugs could play a role in reducing drinking and smoking at the same time.
“A single drug to treat both alcohol and smoking could efficiently and significantly improve health. Hazardous alcohol use and smoking occur frequently, and both threaten health by increasing the risk of cardiovascular disease, cancer, and other important health outcomes,” says the study’s lead author, Dr. Hilary Tindle, of the Vanderbilt University Medical Center, in a news release.
Together with colleagues from the Boston Medical Center and the First Pavlov State Medical University in Russia, Dr. Tindle studied 400 people living with HIV. Researchers are increasingly focusing on treating other conditions in people with HIV because there are now effective treatments for the virus.
They recruited volunteers who self-identified as risky drinkers and smokers and followed them for a year. The researchers wanted participants who drank five or more days per month (defined as five or more drinks in a day for men and four or more for women) and who smoked five or more cigarettes per day.
The study included placebo-controlled drugs, so neither the participants nor the researchers knew which drug they were taking. Published in Open JAMA Networkthe study found that after three months, alcohol consumption decreased regardless of the anti-smoking treatment participants used.
“It was gratifying to see high-risk research participants included in NIH-funded research,” says the study’s principal investigator, Matthew Freiberg, MD, MSc.
“Not only are they living with HIV, but they also have a high burden of hepatitis, polysubstance use, and mental health issues. Such participants are often excluded from drug trials. If a drug as simple as nicotine replacement could help them, that would be a win.”
Nicotine replacement therapy (patches, gum, and sprays) is widely available at relatively low cost. However, scientists have rarely considered them to be an impediment to drinking. Cytisine has been available since the 1960s.
“Another important observation in our post-hoc analysis was that alcohol consumption rates were lower and alcohol abstinence rates were higher among people who quit compared to those who continued to smoke. These results need further study to understand whether the findings were directly due to medications, smoking cessation, or both,” adds Jeffrey Samet, MD, MA, MPH, of the Boston University Schools of Medicine and Public Health.
Dr. Tindley adds that much remains to be learned about how the study drugs, called nicotinic acetylcholine receptor agonists, may work to reduce alcohol consumption, but that the work has shown that these drugs target the receptors of the nervous system that promote voluntary abstinence.
South West News Service writer Danny Halpin contributed to this report.