"Drinking coffee and smoking cigarettes are part of the culture of AA, but we knew little about the degree to which this occurred, how much more prevalent these behaviors were compared to the general American population, or why AA participants actually drank coffee or smoked cigarettes," said Peter R. Martin, professor of psychiatry and pharmacology, director of the Vanderbilt Addiction Center at the Vanderbilt University School of Medicine, and corresponding author for the study.
Martin and his colleagues asked participants (n=289) in all open AA meetings during the summer of 2007 in Nashville to self-report a variety of information: a "timeline followback" for coffee, cigarette and alcohol consumption, the AA Affiliation Scale, coffee consumption and effects questions, the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects Questionnaire.
"The most important finding was that not all recovering alcoholics smoke cigarettes while almost all drink coffee," said Martin.
They found that 88.5 percent of AA attendees consumed coffee and approximately 33 percent drank more than four cups per day.
The most common self-reported reasons were because of coffee's stimulatory effects: feeling better, better concentration, greater alertness.
It was also found that more than half of the respondents, 56.9pct, smoked cigarettes.
Of these, those, 78.7 percent smoked at least half a pack per day, and more than 60 percent were considered highly or very highly dependent. The most common self-reported reasons were because of smoking's reduction of "negative affect," which refers to depression, anxiety and irritability.
"Many of these negative affective states are described by patients as contributors or triggers to relapse after periods of sobriety," said Martin.
Robert Swift, professor of psychiatry and human behaviour at Brown University Medical School, noted that little is known about coffee's role vis-ā-vis abstinence, whether drinking coffee makes it easier or harder to stay sober.
"It's possible that coffee is even a gateway drug, with coffee drinking beginning at about the time persons begin using alcohol. In addition, a potential negative interaction is coffee's known negative effects on sleep. Many alcoholics in long-term recovery frequently have trouble with sleep, and coffee consumption could make sleep problems worse."
"I think that it is important for alcohol researchers and clinicians to know that alcoholics, even those who do not use other illicit drugs, are not just addicted to alcohol, but use other psychotropic drugs like caffeine and nicotine," said Swift.
Results will be published in the October issue of Alcoholism: Clinical and Experimental Research and are currently available at Early View.