Is The link Between Vaping and Alcohol Consumption a Causational one?
Various studies have indicated a relationship between vaping and the use of other substances, including alcohol. But what has science told us about this relationship? Does the use of one substance lead to the use of another? Or is a tendency to self-medicate increase the likelihood of using multiple substances?
A 2015 study by researchers at Baylor College of Medicine looking into why drinking makes smokers and ex-smokers crave cigarettes more than usual, suggested that nicotine is the culprit. The research team said that the substance “tricks” the brain into creating memory associations between environmental cues and smoking behavior.
“Our brains normally make these associations between things that support our existence and environmental cues so that we conduct behaviors leading to successful lives. The brain sends a reward signal when we act in a way that contributes to our well being,” said Dr. John A. Dani, professor of neuroscience at BCM and co-author of the study published in Neuron. “However, nicotine commandeers this subconscious learning process in the brain so we begin to behave as though smoking is a positive action.”
Similarly, a new study published in Substance Use and Misuse, found a strong relationship between vaping and binge drinking. The research team analyzed data from 51,872 US adolescents (grades 8, 10, 12, years: 2017–2019) from the Monitoring the Future survey, which is an ongoing study using annual surveys to track the behaviours of U.S. students.
The analysed data indicated strong associations between nicotine use, cannabis use and binge drinking, particularly for the highest levels of use of each. This led the researchers to conclude that vaping may lead and/or increase the use of both. However, previous research has shown that such a simplistic conclusion, inferring causation because of this correlation, is deeply flawed.
The nature vs. nurture debate
In fact, more recent studies keep suggesting that multiple factors are involved in the relationship between nicotine and alcohol consumption. A study involving almost 3.4 million people with diverse ancestries has identified thousands of genetic variants that link tobacco and alcohol use. Titled, “Genetic diversity fuels gene discovery for tobacco and alcohol use” the study found over 3,500 genetic variations that potentially affect smoking and drinking behaviour.
Published in Nature on December 7th, the study confirmed that although both behaviours are influenced by environmental and social factors, there is evidence that genetics can affect tobacco and alcohol consumption. “We’re at a stage where genetic discoveries are being translated” into clinical applications, said study author Dajiang Liu, a statistical geneticist at Penn State College of Medicine in Hershey, Pennsylvania. “If we can forecast someone’s risk of developing nicotine or alcohol dependence using this information, we can intervene early and potentially prevent a lot of deaths.”
Similarly, a study of high school seniors in the U.S., found that there is a personality aspect involved and teens who crave excitement are more likely to use multiple illicit substances, including alcohol and vaping products.
However, the same study also highlighted an environmental factor. Researchers Kevin Tan and Douglas C. Smith, found that those teens who are less satisfied with their lives and seek out risky and exciting experiences as a result, are the ones more likely to use multiple illicit substances regularly, including nicotine via e-cigarettes. Additionally, found this study, the participants’ attitude towards vaping also reflected how they viewed other substances.
Self-medicating with alcohol and nicotine
The environmental factor was also highlighted in a study conducted among Czech and Slovak participants, looking into the relationship between various types of childhood trauma, certain long-term diseases and alcohol and nicotine use disorder. Titled, “Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples,” the current study was published in BMC Public Health.
Data on selected long-term diseases, alcohol and nicotine use disorder and childhood maltreatment, were collected via questionnaires. After this the research team used logistic regression models to assess the relationships between childhood maltreatment, disease and substance use.
The compiled responses indicated a relationship between alcohol and nicotine use disorder and childhood maltreatment. “There is a higher occurrence of some long-term diseases (such as diabetes, obesity, allergy, asthma) and alcohol and nicotine use disorder,” reported the researchers. They concluded that emotional abuse predicts the occurrence of all the studied long-term diseases, and the consumption of alcohol and tobacco.