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VA RESEARCH: SMOKING INTERFERES WITH THINKING
AND
MEMORY IN RECOVERING ALCOHOLICS -- "This
suggests
that continued smoking during abstinence from
alcohol may adversely affect recovery."
Story here...
http://pub.ucsf.edu/
newsservices/releases/200706291/
Story below:
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Smoking interferes with thinking and memory in
recovering alcoholics
After six to nine months of abstinence from alcohol, recovering
alcoholics who were also chronic smokers showed a significantly lower
rate of improvement in tests of memory, reasoning, judgment, and
visual/spatial coordination than non-smoking recovering alcoholics in a
study conducted by researchers at the San Francisco VA Medical Center (SFVAMC).
Not only did the smokers improve less, but their overall scores were
lower than the non-smokers on most neurocognitive measures tested by the
researchers.
“This suggests that continued smoking during abstinence from alcohol may
adversely affect recovery,” says Timothy Durazzo, PhD, the study’s lead
author and a research scientist in radiology at SFVAMC.
The study appears in the July, 2007 issue of Alcoholism: Clinical &
Experimental Research.
Durazzo, who is also an assistant adjunct professor of radiology at the
University of California, San Francisco (UCSF), says the study is
significant in light of previous research indicating that 60 to 80
percent of people who seek treatment for alcoholism are chronic smokers.
“It’s well-established that chronic alcohol abuse leads to abnormalities
in brain neurobiology and neurocognitive function, and it’s also been
shown that smoking itself leads to neurobiological and neurocognitive
dysfunction,” he says. “We wanted to learn what effect continued chronic
smoking might have on changes in neurocognitive function during
abstinence from alcohol. This issue had not been investigated before.”
The researchers compared neurocognitive function among 13 non-smoking
recovering alcoholics and 12 actively smoking recovering alcoholics
recruited from two substance abuse recovery programs in San Francisco.
After approximately one month of self-reported abstinence from alcohol,
the subjects were tested on an array of neurocognitive abilities known
to be affected by chronic alcohol abuse: auditory/verbal learning and
memory; visual/spatial learning and memory; cognitive efficiency (speed
and accuracy of intellectual task performance); executive skills (higher
order thinking, reasoning, judgment, and planning); processing speed;
working memory (short-term memory); motor functioning; and postural
stability. The results were compared with those of 22 non-smoking, light
drinking controls.
After six to nine months of alcohol abstinence, the subjects and
controls were re-tested. The smokers showed significantly less
improvement than the non-smokers in cognitive efficiency, executive
skills, working memory, and visual/spatial learning and memory. Overall,
their performance in tests of auditory/verbal learning and memory,
cognitive efficiency, executive skills, processing speed, and working
memory was inferior to that of the non-smokers.
Additionally, the smokers demonstrated lower recovery in markers of
neuronal integrity and cell membrane health than the non-smokers.
“This indicates that the smokers showed less recovery over time and were
functionally inferior to the non-smokers at six to nine months of
abstinence,” observes Durazzo. The controls showed no significant change
over time.
“Overall, our studies with alcoholics, both those who receive treatment
and those who do not, provide converging lines of evidence suggesting
that chronic cigarette smoking adversely affects recovery of both
neurobiology and neurocognition in people who drink,” says principal
investigator Dieter Meyerhoff, Dr.rer.nat., SFVAMC radiology researcher
and professor of radiology at UCSF. “These studies contribute to the
growing body of data linking chronic smoking to brain injury and
cognitive dysfunction.”
Durazzo says that the exact mechanisms by which smoking affects
cognition and brain neurobiology have yet to be determined. He observes
that the distinction must be made between nicotine by itself, which is
found in cigarettes and has been shown in some studies to enhance
cognition over the short term, and cigarette smoke, “which contains at
least four thousand different compounds, including a number of
carcinogens and other toxins. We feel that it is most likely the
cumulative effect of chronic exposure to the noxious compounds in the
smoke that might be affecting smokers’ recovery.”
Durazzo cautions that because of the small number of subjects, the study
results are preliminary and should not be generalized to all recovering
alcoholics.
Nonetheless, he says that the long-term benefit of quitting alcohol and
tobacco simultaneously is becoming more and more apparent to researchers
and clinicians. “In terms of addiction, it’s been shown that alcohol and
nicotine reinforce each other’s rewarding properties. Alcoholics tend to
smoke, and smoking may serve as a potential cue or trigger for the urge
to drink. So if you eliminate a trigger for alcohol craving, you may
have a better chance of staying sober.”
Durazzo also points out that the mortality rate associated with chronic
cigarette smoking is four times greater than mortality related to
alcoholism. “Simply for that reason, it may be advisable to encourage
individuals seeking treatment for alcoholism to consider participating
in a smoking cessation program at the same time.”
Durazzo says the next step for the researchers is a comparison of
physical changes in the brain –– volume, metabolites (the chemical
products of brain metabolism), and blood flow –– in the same group of
subjects during extended abstinence from alcohol. “Those data are being
analyzed now,” he reports, “and we hope to learn to what degree these
changes relate to the differences we have observed in neurocognitive
recovery in smoking and non-smoking alcoholics.”
Coauthors of the study are Johannes C. Rothlind, PhD, of SFVAMC and UCSF;
Stefan Gazdzinski, PhD, of UCSF and the Northern California Institute
for Research and Education (NCIRE); and Peter Banys, MD, of SFVAMC and
UCSF.
The research was supported by a grant from the National Institutes of
Health that was administered by NCIRE.
NCIRE - the Veterans Health Research Institute - is the largest research
institute associated with a VA medical center. Its mission is to improve
the health and well-being of veterans and the general public by
supporting a world-class biomedical research program conducted by the
UCSF faculty at SFVAMC.
SFVAMC has the largest medical research program in the national VA
system, with more than 200 research scientists, all of whom are faculty
members at UCSF.
UCSF is a leading university that advances health worldwide by
conducting advanced biomedical research, educating graduate students in
the life sciences and health professions, and providing complex patient
care.
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Larry Scott --
