Table 1.

Studies examining the effect of tobacco cessation or quitting smoking on substance use outcomes (N=24)

	Authors (Year)	Study Design	Sample Description*	Smoking Variable Assessed	SU Outcome of Interest	Cessation/Treatment	Synopsis of Findings
					Positive Impact
1.	Berg, Piper, Smith, Fiore, Jorenby (2015)	Secondary analysis of RCT, bupropion, NRT, counseling	N=1,301, mean age 45, 59% female, 84% white, 48% history alcohol abuse, 10% history of alcohol dependence, smokers	N/A, investigated changes pre and post target quit date	Mean number of drinks per day 2 weeks pre and post target quit date	Smoking Cessation	Positive Generally, alcohol use decreased post-target quit date. Smokers who reported less pre-quit alcohol use, as well as smokers who were female, non-white, and had a history of alcohol dependence tended to use less alcohol post-quit
2.	Magee, Winhusen (2015)	Secondary analysis of multisite RCT, SUD treatment with or without smoking cessation treatment, counseling, bupropion, contingency management	N=538, mean age 36, 48% female, adults with cocaine or methamphetamine SUD	N/A, investigated impact of smoking cessation intervention	Stimulant craving	Smoking Cessation	Positive Smoking cessation eliminated coupling between nicotine craving and stimulant craving, γ = −.07, p = .39. Conclusions: Contrary to concerns about nicotine abstinence during substance dependence treatment, increases in nicotine craving may be associated with later reductions in stimulant craving and use
3.	Cavazos-Rehg, Breslau, Hatsukami, Krauss, Spitznagel, Grucza, Salyer, Hartz, Bierut (2014)	Prospective cohort, NESARC	N=4,853, adults, 48% female, 77% white	Usual number of cigarettes per day, self-report	Past year diagnosis DSM-IV alcohol use disorder or drug use disorder	Smoking Cessation	Positive Among daily smokers who had current or lifetime history diagnosis of the outcome of interest at Wave 1, quitting by Wave 2 predicted a decreased risk of mood/anxiety disorder (aOR 0.6, 95% CI 0.4, 0.9) and alcohol disorder (aOR 0.7, 95% CI 0.5, 0.99) at Wave 2. Among daily smokers with no lifetime history diagnosis of the outcome of interest at Wave 1, quitting smoking by Wave 2 predicted a decreased risk of drug use disorder at Wave 2 aOR 0.3, 95% CI 0.1, 0.9).
4.	Dawson, Goldstein, Grant (2013)	Prospective cohort	N=14,885, adult past-year ≥ monthly drinkers	Smokers at baseline but not during year preceding follow-up, self-report	One year alcohol abstinence	Smoking Cessation	Positive Smoking cessation associated with drinking cessation over follow-up, OR=2.82 (95% CI=1.62–4.92) to 3.45 (2.20–5.39)
5.	Piper, Rodock, Cook, Schlam, Fiore, Baker (2013).	RCT, bupropion, NRT, counseling	N=1,470, mean age 45, 58% female, 84% white, smokers	7-day point prevalence abstinence, biochemically verified (breath CO)	Past year SUD diagnosis	Smoking Cessation	Positive Participants who were smoking at the Year 3 follow-up were more likely to have developed and maintained a substance use or major depressive disorder by that time than were individuals who were abstinent at Year 3
6.	Metrik, Spillane, Leventhal, Kahler (2011)	RCT, counseling, NRT, brief alcohol intervention	N=216, mean age 42, 45% female, 91% white, heavy drinkers seeking smoking cessation treatment	N/A, investigated impact of smoking cessation intervention	Number of drinks/week, percent of marijuana use days	Smoking Cessation Treatment Intervention	Positive All participants made large reductions in weekly alcohol consumption during the trial, with weekly marijuana users also reducing their marijuana use. Frequent marijuana smokers may benefit from smoking cessation even when not explicitly discussed
7.	Tsoh, Chi, Mertens, Weisner (2011)	Retrospective cohort/chart review	N=1,951, adults, 39% female, 75% white, Kaiser patients from 1994–98	Current cigarette smoking, self-report	1 year alcohol or drug abstinence at 5, 7, and 9 years; past-year remission SUD	Smoking Cessation	Positive Stopping smoking during the first year after substance use treatment intake predicted better long-term substance use outcomes through 9 years after intake
8.	Brown, Strong, Abrantes, Myers, Ramsey, Kahler (2009)	RCT, motivational interviewing, brief advice	N=191, adolescents mean age 15, 62% female, 95% white, mental hospital inpatients	N/A, investigated impact of smoking cessation intervention	Percentage of days with substance use (alcohol and illicit drugs)	Smoking Cessation Treatment Intervention	Positive The results of this study suggest that MI for smoking cessation had a significant effect in preventing an increase in substance use during the first 6 months following hospitalization
9.	de Dios, Vaughan, Stanton, Niaura (2009)	Multi-site prospective cohort	N=1,779, adolescents mean age 16, 30% female, 57% white, in SUD treatment	Current cigarette smoking, self-report	Relapse to alcohol and marijuana; time to relapse to alcohol and marijuana	Smoking Cessation	Positive Persistent smokers and smoking initiators had significantly greater odds of alcohol and marijuana relapse and shorter periods to marijuana relapse at follow-up compared with quitters
10.	Myers, Doran, Brown (2007)	Prospective cohort, secondary analysis	N=123, adolescents, mean age 16, 41% female, 81% white, in SUD treatment	Smoking abstinence for > 1 year, self-report	Alcohol use trajectory (abstainers, infrequent drinkers, worse over time, frequent drinkers)	Smoking Cessation	Positive Larger proportion of quitters (v. persistent smokers) were alcohol abstainers compared to frequent drinkers
11.	Satre, Kohn, Weisner (2007)	Prospective cohort	N=598, smokers: n=315, mean age 36, 44% female, 76% white, non-smokers: n=283, mean age 40, 42% female, 71% white, Kaiser, CA, admitted 1997–1998, health plan members	Current cigarette smoking, self-report	Addiction Severity Index scores, 30 day abstinence from alcohol and drugs	Smoking Cessation	Positive Smokers were less likely to be abstinent from alcohol and drugs in the prior 30 days (48.3% vs. 64.0%), and had higher Addiction Severity Index scores
					Null Impact
12.	Alessi and Petry (2014)	RCT, frequent monitoring and behavioral support or that plus contingency management	N=45 – behavioral support: N=21, 100% male, mean age 37, 43% Black, 48% European American; contingency management: N=24, 100% male, mean age 38, 17% Black, 79% European American	Percent of days CO-negative (biochemically validated)	Study attendance, study adherence, days of self-reported drug use (biochemically validated)	Smoking Cessation Treatment Intervention	Null No study withdrawals, no difference by treatment arm for adherence, days of self-reported substance use, or drug-positive urine tests.
13.	Kahler, Borland, Hyland, McKee, O’Connor, Fong, Cummings (2010)	Prospective cohort	N=3,614, mean age 42, 47% female, 95.8%, adult daily smokers from AU, CA, UK, US	Smoking abstinence for > 6 months, self-report	Drinking frequency, number of drinks per day and heavy or “binge” drinking frequency	Smoking Cessation	Null No difference in reduction in drinking by quitters compared to non-quitters
14.	Callaghan, Brewster, Johnson, Taylor, Beach, Lentz (2007)	Retrospective cohort, NRT available on request	N=520, adolescents mean age 17, 57% female, 39% Aboriginal ancestry, in SUD treatment	N/A, investigated impact of smoking ban at SUD treatment facility	SUD treatment enrollment and treatment completion	Smoking Cessation	Null The total smoking ban was not associated with a lower proportion of adolescent smokers seeking treatment or a lower treatment completion rate among smokers compared to nonsmokers
15.	Rohsenow, Tidey, Martin, Colby, Sirota, Swift, Monti (2015)	RCT, contingent vouchers, motivational interviewing, brief advice	N=184, mean age 35, 55% female, 83% white, smokers in SUD treatment	N/A, investigated impact of smoking cessation intervention	Number of heavy drinking days and biochemically verified number of drug use days at each follow up and relapse at 1 year	Smoking Cessation Treatment Intervention	Null No differential effects on drug use
					Mixed Impact (positive and null)
16.	Lisha, Carmody, Humfleet, Delucchi (2014)	Secondary analysis of 2 RCTs, smoking cessation interventions, NRT, counseling, estimated both synchronous (within day) and lagged (across day) forecasts between smoking and alcohol use	N=302, mean age 48, 9% female, 50% white, adults with HIV & adults in alcohol use disorder treatment	Number of cigarettes, timeline follow-back, 7-day point prevalence abstinence, biochemically verified (breath CO)	Alcohol use number of drinks	Smoking Cessation	Positive & null by subgroup/Null overall In the overall sample, there was no difference in alcohol use between those who stopped smoking (even for one day) and those who never stopped (t(300) = 0.08, p = .93). When broken up by study there was a significant reduction in the alcohol dependent sample: t(137) = 2.88, p < .0001. The mean number of drinks was 29.76 (SD = 90.9) for those who stopped v. 131.7 (SD = 324.5) for those who did not.
17.	Reitzel, Nguyen, Eischen, Thomas, Okuyemi (2014)	Secondary analysis of RCT, NRT, self-help guide, counseling	N=427, mean age 44, 25% female, 35% white, homeless adult daily smokers interested in quitting smoking	7-day point prevalence abstinence, biochemically verified (breath CO)	Number of drinking days of 30; drinks per drinking day; number of heavy drinking days; number of days cocaine or mj/hash or heroin and any drug	Smoking Cessation	Positive (alcohol)/Null (drugs) Smoking abstinence (CO-verified) was associated with fewer drinking days (P = 0.03), fewer drinks consumed on drinking days (P = 0.01), and lower odds of heavy drinking (P = 0.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin or any drug use
18.	Winhusen, Kropp, Theobald, Lewis (2014)	Secondary analysis of multisite RCT, SUD treatment with or without smoking cessation treatment, counseling, bupropion, contingency management	N=249, baseline demographics reported by follow-up smoking status, continued smoking: N=174, mean age 38, 49% female, 61% white, smoking abstinent: N=75, mean age 36, 37% female, 55% white, adults with cocaine or methamphetamine SUD	7-day point prevalence abstinence, biochemically verified (breath CO)	Stimulant abstinence (biochemically verified)	Smoking Cessation	Positive (cocaine)/Null (methamphetamines) A significant effect was found for the cocaine-dependent subsample (N=147) in which participants who stopped smoking were abstinent for illicit stimulants an average of 78.2% of the post-smoking-quit weeks (weeks 4–10) relative to 63.6% in participants who continued smoking (χ2(1)=8.55, p<.01, d=0.36). No significant effects were found for the sample as a whole (N=249) or for the methamphetamine-dependent subsample (N=102).
19.	Stahre, Toomey, Erickson, Forster, Okuyemi, Ahluwalia (2013)	RCT, counseling	N=755, mean age 45, 67% female, African American adults	7-day point prevalence abstinence, self-report	Prevalence and frequency of past 30-day binge drinking and average daily alcohol consumption	Smoking Cessation	Positive (short term)/Null (long term) Individuals who quit smoking within the first 8 weeks of the study reported lower past 30-day binge drinking prevalence at week 8 than those who did not quit during the first 8 weeks (P = .035), but the effect was not sustained at the end of the study (week 26)
20.	Campbell, Chi, Sterling, Kohn, Weisner (2009)	Prospective cohort	N=419, adolescents mean age 16, 34% female, 49% white, recruited when entering SUD treatment	Abstinence for previous 6 or 12 months, self-report	SU self-report follow-up data validated on subsample at 12 months w/urinalysis, abstinence from drugs and alcohol	Smoking Cessation	Positive (drugs)/Null (alcohol) Self-initiated tobacco cessation at 6 months, and at both 6 and 12 months, were related to higher odds of drug abstinence but not alcohol abstinence
21.	Myers, Prochaska (2008)	RCT, group counseling	N=54, adolescents mean age 16, 22% female, 69% white, outpatient SUD treatment in Southern California	N/A, investigated impact of smoking cessation intervention	Total days of substance use at the 3-and 6-month follow up time points	Smoking Cessation Treatment Intervention	Positive (short term)/Null (long term) Participants who received smoking cessation intervention had significantly fewer days of substance use than controls at the 3-months, but not at 6-months follow-up
22.	Prochaska, Hall, Tsoh, Eisendrath, Rossi, Redding, Rosen, Meisner, Humfleet, Gorecki (2008)	RCT, smoking cessation intervention, computer-based intervention, counseling	N=322, depressed smokers in mental health outpatient treatment	7-day point prevalence abstinence, biochemically verified (breath CO)	Alcohol, mj, stimulant, opiate use (y/n) between follow-ups		Positive (alcohol)/Null (drugs) Participants who successfully stopped smoking reported less alcohol use than did participants who continued smoking. No difference in drug use
23.	Brook, Balka, Ning, Brook (2007)	Prospective cohort	N=473, adolescents mean age 14, 51% female, 51% black, 49% Puerto Rican	Current cigarette smoking, self-report	Alcohol dependence, illicit drug dependence, alcohol and illicit drug dependence	Smoking Cessation	Positive (quitters v. early starters & continuous) Null (quitters v. late starters) Early starting continuous smokers more likely than quitters report alcohol dependence (OR 3.72) and illicit drug dependence (3.21). There was no difference between late-starting smokers and quitters
					Mixed Impact (negative and null)
24.	Fu, Kodl, Willenbring, Nelson, Nugent, Gravely, Joseph (2008)	Secondary analysis of RCT, smoking cessation intervention, NRT, counseling (concurrent or delayed smoking cessation treatment)	N=459, mean age 40, 30% female, 83% white, adults in alcohol use disorder treatment	7-day point prevalence abstinence, self-report (25% subsample biochemically verified)	6-months alcohol abstinence @ 6, 12, 18 months; time to first alcohol use; black/white differences	Smoking Cessation Treatment Intervention	For whites: alcohol abstinence outcomes were consistently worse in concurrent group than delayed group, but not for blacks