Cigarette smoking initiation during college predicts future alcohol involvement: A matched-samples study

Abstract

Objective: Little is known about the relationship between cigarette smoking initiation and subsequent alcohol involvement. To address this question, the present study compared alcohol use between students who initiated smoking during college and a matched sample of never-smoking students. We hypothesized greater increases in alcohol involvement among smoking initiators, mediated by exposure to cigarette use situations. Method: Included in the present study were 104 Chinese American and Korean American undergraduates who at baseline reported never having smoked a cigarette. Subjects were drawn from 433 participants in a naturalistic longitudinal study of tobacco use who were assessed annually each year in college. Cigarette smoking status was assessed annually as part of a structured interview. Initiators and never-smokers were matched on gender, ethnicity, baseline alcohol use, parental smoking status, and behavioral undercontrol. Results: As predicted, participants who initiated smoking during college reported signifi cantly greater increases in the number of past-30-day total drinks consumed and reported greater prevalence of heavy drinking episodes. The effect of smoking initiation on the change in the number of past-30-day drinks at the fi nal assessment was partially mediated by exposure to smoking. Exploratory analyses indicated that greater recent smoking signifi cantly predicted increased alcohol consumption over and above the effect of exposure. Conclusions: Students who initiate smoking during college appear at risk for increased alcohol involvement. Part of this risk is explained by environmental contextual factors, specifi cally exposure to situations involving other smokers that also may result in greater exposure to alcohol use.

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