Cigarette smoking and the lifetime alcohol involvement continuum

Christopher W. Kahler, David R. Strong, George D. Papandonatos, Suzanne M. Colby, Melissa A. Clark, Julie Boergers, Raymond Niaura, David B. Abrams, Stephen L. Buka

Research output: Contribution to journalArticlepeer-review


Greater understanding of how alcohol use relates to the initiation, progression, and persistence of cigarette smoking is of great significance for efforts to prevent and treat smoking and excessive drinking and their substantial combined iatrogenic effects on health. Studies investigating the relationship between levels of alcohol involvement and smoking have typically been limited by analytic approaches that treat drinking behavior and alcohol use disorder diagnoses as separate phenomena rather than as indicators of a single latent alcohol involvement dimension. The purposes of the present study were (a) to create a lifetime index of alcohol involvement that integrates information about alcohol consumption and alcohol problems into a single measure and (b) to relate this index to initiation of smoking, progression from initiation to daily smoking, progression from initiation to dependence, and persistence of smoking. Rasch model analyses of data from 1508 middle-aged (34-44 years) adults showed that creating an additive index of lifetime alcohol involvement was psychometrically supported. Significant quadratic effects of alcohol involvement on initiation, progression, and persistence of smoking demonstrated that there were specific regions of the alcohol involvement continuum that were particularly strongly related to increased smoking. These results provide the most comprehensive depiction to date of the nature of the relationship between lifetime alcohol involvement and lifetime cigarette smoking and suggest potential avenues for research on the etiology and maintenance of smoking and tobacco dependence.

Original languageEnglish (US)
Pages (from-to)111-120
Number of pages10
JournalDrug and alcohol dependence
Issue number1-2
StatePublished - Jan 11 2008


  • Alcohol
  • Alcohol use disorders
  • Item response modeling
  • Rasch model
  • Smoking
  • Tobacco

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


Dive into the research topics of 'Cigarette smoking and the lifetime alcohol involvement continuum'. Together they form a unique fingerprint.

Cite this