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Smoking may interfere with alcohol recovery

Cigarette smoking is common among individuals with alcohol use disorder (AUD), and research suggests that smoking may interfere with alcohol recovery. Mon et. al. found that smoking slows the healing of brain damage during alcohol recovery (2009).

Several studies have shown that AUD can damage the brain. AUD brain damage, commonly visible in the frontal cortex and parietal cortex, is at least partially reversible with sustained abstinence from drinking.

Magnetic resonance imaging (MRI) can show the extent of brain damaging by illustrating blood flow. Cerebral perfusion is a measure of the blood flow to brain tissue. Blood not only carries nutrients to the brain but also carries away metabolic byproducts. Good blood flow indicates healthy brain functioning.

“In general, AUDs are associated with reduced perfusion,” said Anderson Mon, co-author of the study and senior research fellow in the department of radiology at the University of California, San Francisco. “With abstinence from alcohol, brain perfusion abnormalities may recover, but there are several factors that may influence recovery, such as age, diet, exercise, genetic predispositions and – the topic of our research – other substances such as tobacco products.”

The researchers measured cerebral perfusion in 19 non-smoking alcohol-dependent patients, 22 smoking alcohol-dependent patients, and 28 age-matched, non-smoking, light-drinking controls. The results of the study showed that chronic smokers experienced significantly less perfusion recovery during abstinence, especially in the frontal lobes.

“The brain’s frontal lobes are involved in higher-order cognitive function, such as learning, short-term memory, reasoning, planning, problem solving, and emotional control,” said Anderson.

“At one week of abstinence, both smoking and non-smoking ALC (alcohol-dependent) had similar frontal and parietal gray matter perfusion, and both groups had lower perfusion than normal controls. However, after five weeks of abstinence, frontal and parietal gray matter perfusion of the non-smoking ALC patients recovered to normal control levels, whereas the smoking ALC group essentially showed no recovery.”

Further, the number of cigarettes smoked per day was negatively correlated with frontal gray matter perfusion measured at 5 weeks of abstinence. In other words, individuals who smoked more cigarettes had slower improvement of perfusion.

This study suggests that individuals seeking alcohol recovery should also be offered access to a smoking cessation program. Some individuals may not be able to give up drinking and smoking at the same time, but those who do will likely experience faster alcohol recovery.  At the very least, individuals in alcohol recovery should be aware that continued smoking will interfere with the healing of brain damage caused alcohol use.

It makes sense for individuals who have multiple addictions to stop all of them at the same time. Drinkers who are also smokers would greatly benefit from stopping both. Instead of needing twice to experience the distress of quitting, would it not make sense to quit both at the same time? However much sense this argument may make, in practice it rarely happens that, for instance, someone quitting drinking will also simultaneously quit smoking. Perhaps the findings of this study will persuade some individuals seeking alcohol recovery also to quit smoking at the same time, or at least not to wait very long before quitting smoking.


Mon A, Durazzo TM, Gazdzinski S, Meyerhoff DJ. The impact of chronic cigarette smoking on recovery from cortical gray matter perfusion deficits in alcohol dependence: Longitudinal arterial spin labeling MRI. Alcoholism: Clinical and Experimental Research. 2009; 33(8): 1314-1321.