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. 1991 Jan 5;302(6767):20–23. doi: 10.1136/bmj.302.6767.20

Cigarette smoking and rate of gastric emptying: effect on alcohol absorption.

R D Johnson 1, M Horowitz 1, A F Maddox 1, J M Wishart 1, D J Shearman 1
PMCID: PMC1668727  PMID: 1991182

Abstract

OBJECTIVE--To examine the effects of cigarette smoking on alcohol absorption and gastric emptying. DESIGN--Randomised crossover study. SETTING--Research project in departments of medicine and nuclear medicine. SUBJECTS--Eight healthy volunteers aged 19-43 who regularly smoked 20-35 cigarettes a day and drank small amounts of alcohol on social occasions. INTERVENTIONS--Subjects drank 400 ml of a radiolabelled nutrient test meal containing alcohol (0.5 g/kg), then had their rates of gastric emptying measured. Test were carried out (a) with the subjects smoking four cigarettes an hour and (b) with the subjects not smoking, having abstained for seven days or more. The order of the tests was randomised and the tests were conducted two weeks apart. MAIN OUTCOME MEASURES--Peak blood alcohol concentrations, absorption of alcohol at 30 minutes, amount of test meal emptied from the stomach at 30 minutes, and times taken for 50% of the meal to leave the proximal stomach and total stomach. RESULTS--Smoking was associated with reductions in (a) peak blood alcohol concentrations (median values in non-smoking versus smoking periods 13.5 (range 8.7-22.6) mmol/l v 11.1 (4.3-13.5) mmol/l), (b) area under the blood alcohol concentration-time curve at 30 minutes (264 x 10(3) (0-509 x 10(3)) mmol/l/min v 140 x 10(3)) (0-217 x 10(3) mmol/l/min), and (c) amount of test meal emptied from the stomach at 30 minutes (39% (5-86%) v 23% (0-35%)). In addition, smoking slowed both the 50% gastric emptying time (37 (9-83) minutes v 56 (40-280) minutes) and the intragastric distribution of the meal. There was a close correlation between the amount of test meal emptied from the stomach at 30 minutes and the area under the blood alcohol concentration-time curve at 30 minutes (r = 0.91; p less than 0.0001). CONCLUSION--Cigarette smoking slows gastric emptying and as a consequence delays alcohol absorption.

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Selected References

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  1. Azpiroz F., Malagelada J. R. Intestinal control of gastric tone. Am J Physiol. 1985 Oct;249(4 Pt 1):G501–G509. doi: 10.1152/ajpgi.1985.249.4.G501. [DOI] [PubMed] [Google Scholar]
  2. Caballeria J., Baraona E., Rodamilans M., Lieber C. S. Effects of cimetidine on gastric alcohol dehydrogenase activity and blood ethanol levels. Gastroenterology. 1989 Feb;96(2 Pt 1):388–392. doi: 10.1016/0016-5085(89)91562-x. [DOI] [PubMed] [Google Scholar]
  3. Caballeria J., Frezza M., Hernández-Muñoz R., DiPadova C., Korsten M. A., Baraona E., Lieber C. S. Gastric origin of the first-pass metabolism of ethanol in humans: effect of gastrectomy. Gastroenterology. 1989 Nov;97(5):1205–1209. doi: 10.1016/0016-5085(89)91691-0. [DOI] [PubMed] [Google Scholar]
  4. Carlson G. M., Ruddon R. W., Hug C. C., Jr, Schmiege S. K., Bass P. Analysis of the site of nicotine action on gastric antral and duodenal contractile activity. J Pharmacol Exp Ther. 1970 Apr;172(2):377–383. [PubMed] [Google Scholar]
  5. Chaudhuri T. K., Fink S. Effect of nicotine gum on gastric emptying. Chest. 1988 Nov;94(5):1122–1122. doi: 10.1378/chest.94.5.1122a. [DOI] [PubMed] [Google Scholar]
  6. Cooper J. D. Determination of blood ethanol by gas chromatography. Clin Chim Acta. 1971 Jul;33(2):483–485. doi: 10.1016/0009-8981(71)90516-x. [DOI] [PubMed] [Google Scholar]
  7. Cotton P. B., Walker G. Ethanol absorption after gastric operations, and in the coeliac syndrome. Postgrad Med J. 1973 Jan;49(567):27–28. doi: 10.1136/pgmj.49.567.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. DiPadova C., Worner T. M., Julkunen R. J., Lieber C. S. Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterology. 1987 May;92(5 Pt 1):1169–1173. doi: 10.1016/s0016-5085(87)91073-0. [DOI] [PubMed] [Google Scholar]
  9. Frezza M., di Padova C., Pozzato G., Terpin M., Baraona E., Lieber C. S. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med. 1990 Jan 11;322(2):95–99. doi: 10.1056/NEJM199001113220205. [DOI] [PubMed] [Google Scholar]
  10. Grimes D. S., Goddard J. Effect of cigarette smoking on gastric emptying. Br Med J. 1978 Aug 12;2(6135):460–461. doi: 10.1136/bmj.2.6135.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gritz E. R., Ippoliti A., Jarvik M. E., Rose J. E., Shiffman S., Harrison A., Van Vunakis H. The effect of nicotine on the delay of gastric emptying. Aliment Pharmacol Ther. 1988 Apr;2(2):173–178. doi: 10.1111/j.1365-2036.1988.tb00685.x. [DOI] [PubMed] [Google Scholar]
  12. Grunberg N. E. Nicotine as a psychoactive drug: appetite regulation. Psychopharmacol Bull. 1986;22(3):875–881. [PubMed] [Google Scholar]
  13. Heddle R., Fone D., Dent J., Horowitz M. Stimulation of pyloric motility by intraduodenal dextrose in normal subjects. Gut. 1988 Oct;29(10):1349–1357. doi: 10.1136/gut.29.10.1349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Holt S. Observations on the relation between alcohol absorption and the rate of gastric emptying. Can Med Assoc J. 1981 Feb 1;124(3):267-77, 297. [PMC free article] [PubMed] [Google Scholar]
  15. Horowitz M., Collins P. J., Shearman D. J. Disorders of gastric emptying in humans and the use of radionuclide techniques. Arch Intern Med. 1985 Aug;145(8):1467–1472. [PubMed] [Google Scholar]
  16. Horowitz M., Maddox A., Bochner M., Wishart J., Bratasiuk R., Collins P., Shearman D. Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. Am J Physiol. 1989 Aug;257(2 Pt 1):G291–G298. doi: 10.1152/ajpgi.1989.257.2.G291. [DOI] [PubMed] [Google Scholar]
  17. Houghton L. A., Read N. W., Heddle R., Horowitz M., Collins P. J., Chatterton B., Dent J. Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal. Gastroenterology. 1988 Jun;94(6):1285–1291. doi: 10.1016/0016-5085(88)90665-8. [DOI] [PubMed] [Google Scholar]
  18. Lewis K. O. Back calculation of blood alcohol concentration. Br Med J (Clin Res Ed) 1987 Oct 3;295(6602):800–801. doi: 10.1136/bmj.295.6602.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. McFarlane A., Pooley L., Welch I. M., Rumsey R. D., Read N. W. How does dietary lipid lower blood alcohol concentrations? Gut. 1986 Jan;27(1):15–18. doi: 10.1136/gut.27.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Miller G., Palmer K. R., Smith B., Ferrington C., Merrick M. V. Smoking delays gastric emptying of solids. Gut. 1989 Jan;30(1):50–53. doi: 10.1136/gut.30.1.50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Müller-Lissner S. A. Bile reflux is increased in cigarette smokers. Gastroenterology. 1986 May;90(5 Pt 1):1205–1209. doi: 10.1016/0016-5085(86)90386-0. [DOI] [PubMed] [Google Scholar]
  22. Nowak A., Jonderko K., Kaczor R., Nowak S., Skrzypek D. Cigarette smoking delays gastric emptying of a radiolabelled solid food in healthy smokers. Scand J Gastroenterol. 1987 Jan;22(1):54–58. doi: 10.3109/00365528708991856. [DOI] [PubMed] [Google Scholar]
  23. Petring O. U., Adelhøj B., Ibsen M., Brynnum J., Poulsen H. E. Abstaining from cigarette smoking has no major effect on gastric emptying in habitual smokers. Br J Anaesth. 1985 Nov;57(11):1104–1106. doi: 10.1093/bja/57.11.1104. [DOI] [PubMed] [Google Scholar]
  24. Valenzuela J. E., Defilippi C., Csendes A. Manometric studies on the human pyloric sphincter. Effect of cigarette smoking, metoclopramide, and atropine. Gastroenterology. 1976 Apr;70(4):481–483. [PubMed] [Google Scholar]

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