# Alcohol dependence and consumption status are related to smoking status: A cross-sectional study of data from the Japan Society and New Tobacco Internet Survey 2023

## TL;DR

This study finds that people who smoke, especially dual smokers, are more likely to have alcohol dependence compared to never smokers.

## Contribution

The study investigates alcohol dependence based on specific smoking types, including dual and heated tobacco product use.

## Key findings

- Dual smokers had the highest rate of alcohol dependence (14.9%) compared to other smoking groups.
- Smoking type and nicotine dependence were strongly linked to alcohol dependence in logistic regression analysis.
- Dual smokers were four times more likely to be alcohol dependent than never smokers.

## Abstract

A significant association has been established between tobacco-smoking and alcohol consumption. However, few studies have investigated this association according to tobacco product type. This study aimed to investigate alcohol dependence according to smoking status.

The analysis targeted 31465 participants of the Japan Society and New Tobacco Internet Survey 2023, including 19927 never smokers (63.3%), 6545 ex-smokers (20.8%), 2461 cigarette smokers (7.8%), 1496 heated tobacco product (HTP) smokers (4.8%), and 1036 dual smokers (3.3%). Participant characteristics, including sex, age, and body mass index (BMI), were recorded. Alcohol-dependence status was defined as an alcohol use disorders identification test (AUDIT) score of >13. The Tobacco Dependence Screener (TDS) test was conducted to assess nicotine dependence.

Participants had a median age 47 years (interquartile range, IQR: 33–62) and a median BMI of 21.6 kg/m2 (IQR: 19.6–24.0). While never smokers showed the lowest AUDIT scores (median: 1), cigarette, HTP, and dual smokers exhibited significantly higher AUDIT scores than never smokers (cigarette: 3, HTP: 4, dual smoker: 4; all p<0.001). Dual smokers showed the highest rate of alcohol dependence (14.9%), followed by HTP smokers (10.7%), cigarette smokers (10.5%), ex-smokers (7.8%), and never smokers (2.2%). In logistic regression analysis, factors related to smoking status – such as number of tobacco products consumed per day, TDS scores, and smoking type – were significantly related to alcohol dependence, along with demographic factors of age and sex. Dual smokers were four times more likely to be alcohol dependent than never smokers (adjusted odds ratio, AOR=4.07; 95% CI: 3.09–5.46).

Smoking status is significantly associated with alcohol consumption status.