Smoking and Drinking: A Dangerous Combo

It has been discovered that both chronic smoking and drinking together causes linked and unlinked injuries to the brain. These are both functional and neurobiological injuries. This is bad news for alcoholics, as they usually not only drink in excess; they often smoke in excess as well. At the Research Society on Alcoholism in Santa Barbara, California, a June 2005 symposium looked at and examined the brain’s reactions to smoking and drinking in regards to functionality and neurobiology.

Smoking and Drinking

Dieter J. Meyerhof, who is an associate researcher at Veterans’ Affairs Medical Center San Francisco and professor of radiology at the University of California, stated the following about the symposium’s findings:

“Recent neuroimaging studies of chronic smokers have shown brain structural and blood-flow abnormalities.” The following specific areas have been shown to be affected: prospective memory, executive functions, psychomotor speed, balance, working memory, visual search speeds, and cognitive flexibility. Meyerhof also mentioned these. He also stated that scientists and researchers believe that these effects take many years to show up and that age accelerates the processes.

Gray matter in the brain has also been proven to thin and deteriorate in those who drink and smoke concurrently. Cigarette smoking has been shown to thin the brain’s cortex as well. Karama, et al. stated in the abstract of their study: “Cigarette smoking is associated with cognitive decline and dementia, but the extent of the association between smoking and structural brain changes remains unclear. Importantly, it is unknown whether smoking-related brain changes are reversible after smoking cessation.” This is important, as it points to the fact that although some improvements in the body occur after quitting smoking specifically, it is unknown whether the brain can heal from the damage. Karama, et al also pointed out that “Smokers need to be informed that cigarettes are associated with accelerated cortical thinning, a biomarker of cognitive aging. Importantly, cortical thinning can persist for many years after smoking cessation. The potential to at least partially recover from smoking-related thinning might serve as a strong motivational argument to encourage smoking cessation.”

Quitting: What Happens?

This brings us to the matter of quitting drinking and smoking. Although results are still unclear at this point, it has been shown that the brain and body can improve at least a little when someone quits. The younger the person, the greater the chances are for healing. A major problem in the area of stopping drinking is that most former drinkers still smoke. It is one of the few things that they can still enjoy, many of them believe, and a cigarette can briefly calm anxiety and quiet cravings for alcohol.

Alcohol has long been deemed the bigger demon of the two habits, and for a long time, most patients were encouraged to put down the drink and not immediately to worry about putting down the cigarette. For many years, the dangers of cigarettes were kept secret. Then, as research became available that points to the many ills that they cause, patients were encouraged to quit. However, if the patient was a heavy drinker or an alcoholic, the stress of quitting cigarettes was believed not to be worth the stress that it would cause the patient who was quitting drinking. This is no longer the case. Heart damage is one of the chief causes of danger to the body from smoking, and other dangers are numerous cancers, arterial structure weakening, and higher blood pressure.

Many smokers now have no choice but to quit when they enter treatment for alcoholism, as most treatment and rehab centers have become non-smoking. It has been found that it may prove beneficial, including in the long run, for a drinker to cut off the sauce and stub out the cigarette at the same time. Heavy drinking has already damaged the drinker’s body, and continuing to smoke will only increase the damages done, in addition to creating new ones.

The Amazing Brain and Its Ability to Bounce Back

It has been proven that the brain suffers damage from heavy drinking, especially the longer it goes on. If a drinker quits at the right time, however, the effects can reverse themselves, and the brain can begin to heal. Continuing to smoke cigarettes inhibits the brain’s ability to recover, and it may not heal at all if the former drinker continues to smoke even after successfully going through the alcohol rehab

Smoking May Make the Former Drinker Pick It Back Up

There have been studies that show that nicotine may actually make someone want to drink more. Scientists and researchers believe that drinks and cigarettes act on the same area of the brain that sees them as rewards. Therefore, continuing to smoke may mean that the alcoholic returns to drinking more often than those who quit smoking as well.

12-Steps and Smoking

In the United States, Alcoholics Anonymous remains the continuing treatment choice of many of those in recovery. There is the component of spirituality in the 12-Steps, and many in recovery find that they wrestle with this aspect if they keep smoking. Addiction to nicotine is just addiction to another substance. This would also be the same for caffeine as well. Many people in recovery would like to find out ways to get rid of these extra addictions in addition to remaining abstinent to alcohol. Those who omit all substances have been shown to lead healthier, more active, and more fulfilling lives.

Heavy Drinkers and Smokers

The following were found in a study by Fucito & Hanrahan:

  • Heavy-drinking smokers are more motivated to change their smoking than drinking.
  • Heavy-drinking smokers perceive that drinking increases their smoking.
  • Many heavy-drinking smokers prefer treatment for both to be integrated.
  • Heavy-drinking smokers prefer personalized feedback about smoking and drinking health effects.

This shows that many of those who drink and smoke may be well aware of many of the ill effects of both, and that they wish for their treatment to be dual in nature; they want both problems addressed and concrete ways to quit and stay quit.


It has been proven beyond a doubt that drinking and smoking respectively damage the body’s organs, systems, and the brain. It has also been demonstrated that quitting one or the other will help the body to heal itself, although the extent of the healing has not been fully discovered yet. When one drinks in excess and smokes cigarettes as well, the effects on the brain and the body are exponentially increased.

Heavy drinkers and smokers are much more aware of the effects as mentioned earlier than ever before. They, also, have been known to request help with both of these problems, and many in recovery express dismay at still having addictions even though they have quit drinking.

Scientists and researchers need to make sure that treatment facilities and 12-step systems continue to educate patients and those already in recovery. There need to be more options for co-addictions, and integration into a new clean lifestyle should be of utmost importance. Activities, job assistance, and other helping options need to be in place for those who have quit drinking so that they can quit smoking as well. They need to be kept busy, and they need to be encouraged to quit smoking in addition to quitting drinking. This will improve not only their health, but also their lives in general as well.


  • Betty Ford Institute Consensus Panel. “What is recovery? A working definition from the Betty Ford Institute” Journal of Substance Abuse Treatment. 20 September 2007. Goldsmith RJ, et al “Towards a broader view of recovery.” Journal of Substance Abuse Treatment March 1993.
  • Fucito, L. M., & Hanrahan, T. H. (2015). Heavy-Drinking Smokers’ Treatment Needs and Preferences: A Mixed-Methods Study. Journal Of Substance Abuse Treatment, 5938-44. doi:10.1016/j.jsat.2015.07.001
  • Karama, S., Ducharme, S., Corley, J., Chouinard-Decorte, F., Starr, J. M., Wardlaw, J. M., … & Deary, I. J. (2015). Cigarette smoking and thinning of the brain’s cortex. Molecular psychiatry, 20(6), 778-785.
  • “Practical steps to smoking cessation for recovering alcoholics.” American Family Physician. Oct. 1998. Mon, A., et al “The Impact of Chronic Cigarette Smoking on Recovery From Cortical Gray Matter Perfusion Deficits in Alcohol Dependence: Longitudinal Arterial Spin Labeling MRI,” Alcoholism: Clinical & Experimental Research August 2009. National Institute on Alcohol Abuse and Alcoholism. “Alcohol and Nicotine.” Alcohol Alert No. 71 January 2007. Substance Abuse and Mental Health Services Administration. “SAMHSA’s Definition and Guiding Principles of Recovery. 22 Dec. 2011