Abstract
Background and Objectives: Behavioral economic purchase tasks are widely used to assess drug demand in substance use disorder research. Comorbid alcohol use is common among cigarette smokers and associated with greater difficulty in quitting smoking. However, demand for alcohol and cigarettes in this population has not been fully characterized. The present study addressed this gap by examining alcohol and cigarette demand among treatment-seeking smokers with alcohol use disorder (AUD).Methods: Alcohol and cigarette demand was assessed among 99 smokers with AUD. We conducted Principal Component Analysis (PCA) and correlational analyses on the demand indices.Results: Participants showed higher demand for alcohol than for cigarettes, as evidenced lower elasticity (resistance to increasing price) and higher Omax (maximum response output for drug). PCA revealed a two-factor structure (Persistence and Amplitude) for both alcohol and cigarette demand indices. Cigarette-related demand indices were positively correlated with nicotine dependence, but alcohol-related demand indices were not associated with alcohol dependence, suggesting dissociation between alcohol demand and use behaviors.Discussion and Conclusions: Our results suggest that smokers with AUD were more resistant to price elevations in relation to reducing alcohol consumption as compared to cigarette consumption, suggesting preferential demand for alcohol over cigarettes. However, it is unclear how acute substance exposure/withdrawal impacts the demand indices.Scientific Significance: Potentially differential alcohol and cigarette demands among smokers with AUD should be considered in the concurrent treatment of smoking and alcohol.
Highlights
Cigarette-related demand indices were positively correlated with nicotine dependence, but alcohol-related demand indices were not associated with alcohol dependence, suggesting dissociation between alcohol demand and use behaviors
Our results suggest that smokers with alcohol use disorder (AUD) were more resistant to price elevations in relation to reducing alcohol consumption as compared to cigarette consumption, suggesting preferential demand for alcohol over cigarettes
Our finding that participants had higher Omax and elasticity in the alcohol purchase task (APT) than in the cigarette purchase task (CPT) suggests that they were willing to allocate more economic resources toward alcohol than cigarettes and were less sensitive to the price escalation of the alcohol than that of cigarettes. These results suggest that alcohol had relatively greater Reinforcing Efficacy (RRE) than cigarettes among smokers with alcohol use disorder
Summary
In the United States, the prevalence of nicotine dependence among individuals with alcohol dependence is 45.4%, while the prevalence of any alcohol use disorder among adults with nicotine dependence is 22.8% [1] These co-dependent individuals have more difficulty quitting smoking [2]. An outstanding problem among those with substance use disorders is their disproportionate valuation of the drug [3] and their disproportionate allocation of resources to obtaining the drug compared to participating in other daily activities [4] This imbalance between drug-related vs regular activities reflects reinforced drug consumption patterns [5, 6], and the differences in how drugs and nondrug reinforcers (e.g., food) exhibit differential reinforcement strengths can be operationalized using a concept known as Relative Reinforcing Efficacy (RRE). The present study addressed this gap by examining alcohol and cigarette demand among treatment-seeking smokers with alcohol use disorder (AUD)
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