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February 20, 2000
6:00 p.m. EST |
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Contact: Beverly Jackson
Michelle Muth
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Nicotine Craving and Heavy Smoking May Contribute to
Increased Use of Cocaine and Heroin
Researchers supported by the National Institute on Drug Abuse (NIDA) have
found that craving for nicotine appears to be linked to increased craving for
illicit drugs among drug abusers who also smoke tobacco. In addition, scientists
say, patients in drug treatment programs may be less likely to successfully
stay off drugs if they are cigarette smokers. These are the findings from two
studies published this month in the journal Experimental and Clinical Psychopharmacology.
The two studies, said NIDA Director Dr. Alan I. Leshner, "add very strong
behavioral evidence to other research that suggests common characteristics
and interactions between tobacco use and opiate and cocaine use. They also
suggest that smoking cessation programs should be offered as part of other
drug treatment programs."
One study, led by Dr. Stephen Heishman at NIDA's Intramural Research Program,
examined the interaction of craving for nicotine and other drugs, using a
technique of "cue-induced craving." The study involved male and female adult
smokers with histories of drug abuse who were not interested in quitting smoking.
In the first part of the study, 18 subjects were asked to listen to scripts-recorded
descriptions of scenes-with pleasant (watching children on a sunny beach),
unpleasant (a friend asking to borrow money), or neutral (doing household
chores) content. At the same time, some of the scripts depicted people expressing
a desire to smoke, while other scripts did not mention smoking. In the second
part of the study, 24 subjects listened to scripts with only positive emotional
content (enjoying the beach, talking on the phone with an old acquaintance,
or visiting friends). These positive scripts included increasingly intense
descriptions of tobacco craving-from no mention of smoking to asking the question
"how could you really enjoy yourself fully unless you were smoking?" After
the subjects listened to the scripts they were asked to rate their urge to
smoke and their desire to use other drugs.
The investigators found that the scripts mentioning smoking and the scripts
containing negative emotional content increased the subjects' experiences
of tobacco craving. And, in the second phase of the study, tobacco craving
increased as the intensity of the craving messages in the scripts increased.
"One of our more interesting findings was that scripts which elicited craving
for tobacco also elicited craving for the subject's drug of choice. This suggests
that real-world situations that produce tobacco craving may also result in
craving for drugs of abuse," Dr. Heishman explained. "These findings may have
important implications for the concurrent treatment of tobacco dependence
and other drug dependencies."
In the second NIDA-supported study, Dominick Frosch, a doctoral student at
San Diego State University/University of California, San Diego Joint Doctoral
Program in Clinical Psychology, and his colleagues at the Integrated Substance
Abuse Program at the University
of California, Los Angeles, studied the relationship between levels of cigarette
smoking and levels of drug use among 32 individuals enrolled in a heroin treatment
program. The participants included heavy (20 to 40 cigarettes per day) smokers,
nonsmokers, and "chippers" who smoked fewer than 5 cigarettes per day. All
of the participants had been in a methadone treatment program for at least
4 months. The researchers evaluated the connection between tobacco smoking
and illicit drug use among the smokers and nonsmokers by using breath and
urine samples from the participants over a 7-day period. They found that the
amount of cocaine and heroin use was directly related to the level of tobacco
use. "The more cigarettes smoked, the more likely the person was to use illegal
drugs," Frosch said.
The National Institute on Drug Abuse is a component of the National Institutes
of Health, U.S. Department of Health and Human Services. NIDA supports more
than 85 percent of the world's research on the health aspects of drug abuse
and addiction. The Institute carries out a large variety of programs to ensure
the rapid dissemination of research information and its implementation in
policy and practice. Fact sheets on the health effects of drugs of abuse and
other topics can be ordered free of charge in English and Spanish by calling
NIDA Infofax at 1-888-NIH-NIDA (644-6432) or 1-888-TTY-NIDA (889-6432) for
the deaf. These fact sheets and further information on NIDA research and other
activities can be found on the NIDA home page at http://www.drugabuse.gov/.
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