Nicotine patches, gums, and nasal sprays for smokers may also help people stop drinking

NASHVILLE, Tenn. — Nicotine patches, gums, and nasal sprays prescribed to help people quit smoking may also cut down on their drinking as well.

Originally designed as the control arm of a clinical trial testing whether anti-smoking prescription drugs would help people consume less alcohol, the study found these common remedies performed just as well. After three months, participants reduced their alcohol consumption regardless of whether they used nicotine replacement therapy or prescription drugs – like varenicline or cytisine.

The researchers say these medications could all play an important role in reducing drinking and smoking at the same time.

“A single medication to treat both risky drinking and smoking could improve health efficiently and significantly. Risky drinking and smoking frequently co-occur, and they both threaten health by increasing risk of cardiovascular disease, cancer and other important health outcomes,” says study lead author Dr. Hilary Tindle from Vanderbilt University Medical Center in a media release.

Along with colleagues from Boston Medical Center and First Pavlov State Medical University in Russia, Dr. Tindle studied 400 people living with HIV. Researchers are increasingly focusing on treating other conditions in people with HIV because there are now effective treatments for the virus.

They recruited volunteers who self-identified as drinking and smoking risky amounts and followed them for a year. The researchers wanted participants who had five or more heavy drinking days a month (defined as having five or more drinks in one day for men and four or more for women) and who those smoked five or more cigarettes a day.

The study featured placebo-controlled medications, so neither participants nor investigators knew which medication they were taking. Published in JAMA Network Openthe study found that after three months, alcohol consumption decreased regardless of which anti-smoking treatment participants used.

“It was gratifying to see high-risk research participants being included in NIH-funded research,” says study principal investigator Matthew Freiberg, MD, MSc.

“They are not only living with HIV, but also have a high burden of hepatitis, multi-substance use and mental health issues. Such participants are often excluded from drug trials. If a medication as simple as nicotine replacement could help them, that would be a win.”

Nicotine replacement therapy – the patches, gums, and sprays – are widely available at relatively low cost. However, scientists have rarely looked at them as a deterrent for drinking. Cytisine has been available since the 1960s.

“Another important observation in our post-hoc analysis was that rates of alcohol consumption were lower, and rates of alcohol abstinence were higher, among the people who quit smoking as compared to those who continued to smoke. These results need further study to understand if findings were due to the medications directly, quitting smoking or both,” adds Jeffrey Samet, MD, MA, MPH, from Boston University Schools of Medicine and Public Health.

Dr. Tindley adds that there is much still to learn about how the study drugs – termed nicotinic acetylcholine receptor agonists – may work to reduce alcohol consumption, but that the work has shown that these drugs target receptors in the nervous system which encourage voluntary abstinence.

South West News Service writer Danny Halpin contributed to this report.

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