Academic journal article Alcohol Research

Co-Occurring Risk Factors for Alcohol Dependence and Habitual Smoking

Academic journal article Alcohol Research

Co-Occurring Risk Factors for Alcohol Dependence and Habitual Smoking

Article excerpt

Smoking and alcohol dependence frequently occur together, and both behaviors are determined in part by genetic influences. The Collaborative Study on the Genetics of Alcoholism (COGA), which is investigating the genetic factors contributing to alcohol dependence, also allows for analyses of the genetic factors determining smoking. Using a sample comprised of alcoholics and their closest (i.e., first-degree) relatives as well as a community-based control sample, COGA investigators found that both alcohol dependence and habitual smoking were transmitted within families. This familial transmission resulted from both common and drug-specific influences, which likely include genetic factors. Further genetic studies (ie., candidate gene studies and genomic screening approaches) have identified several DNA regions that may contain genes that confer a susceptibility for alcoholism. Some of those genes also may contribute to the risk for habitual smoking. KEY WORDS: AOD (alcohol or other drug) dependence potential; smoking; gene expression; dopaminergic receptors; genetic linkage; AODR (AOD related) genetic markers; genetic screening method; chromosome; DNA replication; genetic variance; risk factors

In the United States, excessive alcohol use is a serious public health problem. At some time in their lives, 19 percent of men and 8 percent of women have been diagnosed with alcohol dependence as defined in the American Psychiatric Association's (APA's) (1994) Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV). Moreover, 6 percent of men and 3 percent of women have experienced symptoms of alcohol dependence in the past year (Grant and Harford 1995). Unfortunately, the prevalence of alcohol dependence has been increasing among younger people (Chatterji et al. 1997), indicating that alcohol dependence may become an ever more prominent public health problem. In addition to causing numerous serious medical disorders (e.g., liver and heart disease), alcohol dependence is associated with costly, adverse social consequences, such as disruption of families, crime, traumatic accidents, and lost productivity. As a result, the annual costs related to alcohol dependence in the United States for 1998 have been estimated at $185 billion (National Institute on Alcohol Abuse and Alcoholism 2000).

At the same time, 25 percent of the U.S. adult population (i.e., approximately 48 million people) can be classified as current smokers (Centers for Disease Control and Prevention [CDC] 1999a). Although the prevalence of smoking has decreased during the past 30 years, little change in smoking rates has occurred since the mid- 1990s. More worrisome, smoking rates have increased among adolescents and young adults in the United States, accompanied by a dramatic increase in tobacco use worldwide (CDC 1999a). Smoking is a leading cause of preventable disability and death and is associated with multiple well-documented adverse health effects, including heart disease, pulmonary disease, and various cancers. The economic burden of smoking is high. Thus, the annual costs attributable to smoking in the United States have been estimated to be $50 billion in direct medical costs plus a similar amount in lost productivity (CDC 1999b).

Alcohol dependence and smoking frequently occur together. Smokers, including those who are nicotine dependent, have an elevated risk for alcohol dependence.1 Thus, smokers in general have a 2.1 times greater risk and nicotine-- dependent smokers have a 2.7 times greater risk of becoming alcohol dependent compared with nonsmokers (Breslau 1995). Similarly, alcohol-dependent people have a greatly increased risk of smoking (i.e., 4.7 times greater) than do non-alcohol-dependent people (Glassman et al., 1990).

Both alcohol dependence and smoking are complex behaviors that are influenced by environmental as well as genetic factors. Various types of research, including studies of identical and fraternal twins, adoptees, and families with multiple alcoholic members have provided evidence for a strong genetic component in the development of alcohol dependence. …

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