Predictors of smoking among patrons of a college bar district: Alcohol intoxication and 5-HTTLPR genotype

Background: Both clinical and non-clinical studies have found associations between alcohol consumption and smoking; however, no studies have examined this association using biological measures of intoxication in natural drinking settings. The current study addresses this gap by assessing the situation-specific relationship between acute alcohol intoxication and smoking in bars and nightclubs.

Methods: Over the course of four nights, we collected self-report data, breath alcohol concentration (BrAC) readings, and oral fluid samples (used to assess genetic markers) from 467 patrons exiting on-premise drinking establishments in a college bar district.

Results: One-way ANOVA results indicated that patrons who smoked tobacco on the night of study and those who smoked marijuana on the night of study consumed more alcohol than non-smoking patrons. Tobacco smoking was found to be significantly associated with elevated alcohol intoxication, whereas marijuana smoking was associated with increased drinking duration. A multivariate logistic regression model revealed a significant association between acute intoxication and smoking on the night of study, adjusting for the effects of habitual smoking behavior, 5-HTTLPR genotype, age, and sex.

Discussions: This investigation is the first known study to link acute alcohol intoxication to specific smoking episodes in a bar and nightclub setting, accounting for confounding factors such as habitual smoking. This study also adds to the literature on the 5-HTTLPR genotype, by identifying the S-allele as a genetic risk factor for smoking among bar patrons, controlling for confounders.