Co-use of alcohol and tobacco among young adult social smokers

Background: Young adults frequently report social smoking. Alcohol use and bar environments may encourage this behavior.

Objective: To examine patterns of alcohol use and quit attempts among young adult social smokers aged 21-26.

Methods: Cross-sectional survey of bar patrons using randomized time location sampling in San Diego, CA (N=1,196, response rate 73%). Self-identified social smokers answered “yes” when asked “Are you a social smoker?” Behavioral social smokers reported smoking mainly or only with others when smoked. Multivariate logistic regression models analyzed the association of alcohol and tobacco co-use and quit attempts with each social smoking behavior, controlling for demographic variables.

Results: 80% of current smokers self-identified as social smokers; 49% of current smokers were behavioral social smokers. A significantly higher proportion of self-identified social smokers reported increased smoking when drinking alcohol or at bars (p<.05), this difference was not seen in behavioral social smokers. Self-identified social smokers were significantly more likely to smoke at least half the time when drinking in bars (OR=1.81, 95% CI: [1.14, 2.87]); behavioral social smokers were less likely (OR=0.44, 95% CI: [0.30, 0.65]). Self-identified social smokers were more likely to report past-year quit attempts (OR=1.59, 95% CI: [1.01, 2.50]), and behavioral social smokers less likely (OR=0.55, 95% CI: [0.38, 0.78]). Both types of social smokers reported alcohol use or bar attendance made it harder to quit.

Discussion: Alcohol and tobacco co-use is common among young adult social smokers, but behavior depends on definition of social smoking; these differences should be addressed in tobacco cessation programs.