Alcohol and cigarettes — quitting both at the same time?

Originally Published: May 8, 2009
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Dear Alice,

I have been a smoker for about 8 years and smoke about a pack per day, I am also an alcholic and now drink about 7 to 10 beers a day, and have been for the past 2.5 years. Last night I decided to quit drinking beer every day and today I am already shakey, nervous, and can't concentrate. I want to quit smoking also so I can join the army. Is it dangreous to quit both at once? Would it be too much stress on my body and mind? And also, would having just one beer a day for the next couple days help with the withdrawl symptoms?

—Aria

Dear Aria,

Congratulations on making the decision to quit smoking and work to overcome your alcoholism. Admitting to problems with substance abuse is often difficult, so it's great that you are being honest with yourself and have made a commitment to quit drinking and smoking. It's not dangerous to quit both simultaneously, but it may more difficult than tackling one problem at a time. A medical treatment program can help you quit both substances safely, while giving you the tools and support to stay substance-free in the long run.

You're not alone in battling two addictions at once. Over 80 percent of alcoholics smoke, and smokers are more likely to be alcoholics compared to non-smokers. Researchers have noted that people who are trying to quit smoking often relapse when they drink. According to one study, it appears that the interaction between nicotine and alcohol can make it more difficult to quit either substance.

As you've experienced, alcoholics who reduce their alcohol intake may have withdrawal symptoms like nausea, sweating, and shaking. Once your body has become dependent on alcohol, it can be dangerous to quit suddenly. In some cases, alcoholics who stop drinking abruptly can develop delirium tremens, or DTs, a form of withdrawal that causes severe mental and neurological problems. Symptoms can include:

  • Body tremors
  • Agitation or irritability
  • Confusion, disorientation, or delirium
  • Decreased attention span
  • Restlessness or excitement
  • Feelings of fear
  • Sensitivity to light, sound, and touch
  • Hallucinations
  • Seizures

DTs is a dangerous condition, so if you experience any of these symptoms call 911 or go to the emergency room immediately. Delirium tremens is most common among alcoholics with a history of withdrawal symptoms who drink over 7 pints of beer or 1 pint of "hard alcohol" each day. According to the drinking habits you described, you may be at risk for DTs by trying to stop drinking on your own. A health care provider or alcohol treatment program can help you quit safely and effectively.

Unlike giving up alcohol, quitting smoking poses no severe health risks. In fact, there are immediate health benefits. Within hours after your last cigarette, your heart rate and level of carbon monoxide in the bloodstream return to normal. If you stop smoking, you may experience some withdrawal symptoms including:

  • Strong cravings
  • Anxiety
  • Irritability
  • Difficulty concentrating
  • Depressed mood
  • Frustration or anger
  • Increased hunger
  • Insomnia
  • Constipation or diarrhea

Despite your commitment, you may find that it's very difficult to quit drinking and/or smoking on your own. You're more likely to be able to stop drinking and smoking, and remain drug-free in the long term, if you seek support from family, friends, and health professionals. An intensive treatment program can help you address the physical and emotional challenges of addiction and quitting. Most studies on quitting smoking agree that having social support and using nicotine replacement options will dramatically increase your chances of succeeding.

If you are a student at Columbia, there are several resources for students struggling with alcoholism and smoking. Since you are experiencing physical withdrawal symptoms, you may want begin by visiting Primary Care Medical Services (PCMS). To make an appointment with a clinician at PCMS call x4-2284 or log on to Open Communicator. PCMS also offers a tobacco cessation program including access to nicotine replacement options and individual cessation support.

You may also find it helpful to talk with a therapist at Counseling and Psychological Services (CPS) about the psychological aspects of dependence and the stresses associated with quitting. To make an appointment at CPS, call x4-2878. For alcohol and smoking cessation resources off-campus, check out the related Q&As below.

It may seem like an immense challenge to confront dual problems with alcohol and smoking, but you've already passed the first hurdle by making a commitment quit both. By gathering support and seeking treatment, you can confront the next challenges and ultimately reach your goal of improving your health and joining the army.

Alice