How Nicotine and Alcohol Each Change the Brain to Increase Craving for the Other

A review described how chronic nicotine and alcohol each alter multiple brain systems including cannabinoid receptors, creating cross-drug changes that lower withdrawal symptoms from each other and increase preference for combined use.

Lajtha, A et al.·Neurochemical research·2010·Moderate EvidenceReview
RTHC-00425ReviewModerate Evidence2010RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

This review examined the neurochemical interactions between nicotine and alcohol, two substances whose use frequently co-occurs.

Chronic nicotine altered multiple brain systems: nicotinic receptors (subunit composition changes), catecholamine, glutamate, GABA levels, and opiate and cannabinoid receptors. Similarly, chronic alcohol affected many of the same systems.

Key interactions included:

- The two substances reduced each other's negative withdrawal symptoms, which may reinforce combined use

- Some brain changes from combined use were additive, while others were opposing

- Effects were sex- and age-dependent, with adolescents generally more sensitive

- Endocannabinoid content was among the systems affected by both substances

The authors noted that the mechanisms by which one drug increases preference for another are complex, multi-component, and likely differ depending on the direction of the interaction.

Key Numbers

Brain systems affected: nicotinic receptors, catecholamines, glutamate, GABA, opioid peptides, cannabinoid receptors, endocannabinoid content. Effects were sex- and age-dependent.

How They Did This

Narrative review examining neurochemical changes induced by chronic nicotine and alcohol, focusing on mechanisms of cross-drug preference enhancement.

Why This Research Matters

Smoking and drinking co-occur at very high rates. Understanding the neurochemical basis for this co-use could lead to treatments that address both substances simultaneously rather than treating them separately.

The Bigger Picture

The interaction between nicotine, alcohol, and the cannabinoid system highlights how substance use is not isolated to single neurotransmitter systems. Each drug changes the landscape for other drugs, creating complex patterns of co-use and cross-dependence.

What This Study Doesn't Tell Us

Narrative review without systematic methodology. Many findings were from animal studies that may not translate to human experience. The complexity of multi-system interactions makes specific conclusions difficult.

Questions This Raises

  • ?Could targeting the endocannabinoid system help treat co-occurring nicotine and alcohol use?
  • ?Do the opposing effects of combined use create unpredictable outcomes?
  • ?Should treatment programs address all co-used substances simultaneously?

Trust & Context

Key Stat:
Nicotine and alcohol each altered cannabinoid receptors and reduced each other's withdrawal
Evidence Grade:
Comprehensive narrative review of primarily preclinical evidence on complex multi-system drug interactions.
Study Age:
Published in 2010. Research on nicotine-alcohol interactions has continued, with increasing attention to the endocannabinoid system as a mediator.
Original Title:
Nicotine: alcohol reward interactions.
Published In:
Neurochemical research, 35(8), 1248-58 (2010)
Database ID:
RTHC-00425

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Why do smoking and drinking go together?

At the brain level, each substance changes neural systems in ways that reduce withdrawal from the other and increase preference. They essentially make each other more rewarding and less aversive, creating a powerful reinforcement loop.

Does the endocannabinoid system play a role?

Yes, both nicotine and alcohol affect endocannabinoid content and cannabinoid receptors. The endocannabinoid system appears to be one of several neural systems that mediate the cross-drug preference enhancement.

Read More on RethinkTHC

Cite This Study

RTHC-00425·https://rethinkthc.com/research/RTHC-00425

APA

Lajtha, A; Sershen, H. (2010). Nicotine: alcohol reward interactions.. Neurochemical research, 35(8), 1248-58. https://doi.org/10.1007/s11064-010-0181-8

MLA

Lajtha, A, et al. "Nicotine: alcohol reward interactions.." Neurochemical research, 2010. https://doi.org/10.1007/s11064-010-0181-8

RethinkTHC

RethinkTHC Research Database. "Nicotine: alcohol reward interactions." RTHC-00425. Retrieved from https://rethinkthc.com/research/lajtha-2010-nicotine-alcohol-reward-interactions

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.