A Prospective, High-Risk Study of the Relationship between Tobacco Dependence and Alcohol Use Disorders


  • This study was conducted at the University of Missouri-Columbia and was supported, in part, by Grant AA- 7231 from the National Institute on Alcohol Abuse and Alcoholism (to K.J.S.). A preliminary version of this study was presented at the Annual Meeting of the Research Society on Alcoholism in Steamboat Springs, CO, in June 1995.

Reprint requests: Kenneth J. Sher, Ph.D., Department of Psychology, University of Missouri, 210 McAlester Hall, Columbia, MO 65211.


This study examined the extent to which tobacco dependence (TD) and alcohol use disorders (AUDs) reciprocally influenced each other in a mixed-gender sample of 452 individuals (n= 232 biological family history of paternal alcoholism, n= 220 no first- or second-degree family history of alcoholism) who were assessed once early in their freshman year of college, ∼3 years later when many were college seniors, and ∼3 years later when many had entered or were entering the work force. AUDs were more prevalent in men than women, in individuals with a family history of alcoholism, and decreased overall with time. TD was more prevalent in those with a family history of alcoholism, showed increasing rates of use over time, and was less prevalent but more stable than AUDs. Transitional probabilities indicated that although a previous AUD or TD diagnosis increased the likelihood of being diagnosed with the other disorder at a later time, comorbid AUDs and TD did not significantly affect the likelihood of recovery from either disorder. Finally, path analysis revealed significant reciprocal relationships between AUDs and TD diagnoses (each predicting the other over time), and significant prediction of AUDs and TD by family history of alcoholism at the first and third times of assessment. Findings supported two general models of AUD/TD comorbidity: a shared vulnerability model and a reciprocal influence model.