Short ReportCrossover associations of alcohol and smoking, craving and biochemically verified alcohol and nicotine use in heavy drinking smokersSmith, Crystal Lederhosa,,b,,c,,d; Jenkins, Garrette; Burduli, Ekaterinaa,,b,,f; Tham, Phoebec; Miguel, Andrea,,g; Roll, Johna,,b,,c; Mcpherson, Sterlinga,,b,,e,,gAuthor Information aProgram of Excellence in Addictions Research bTranslational Addictions Research Center cElson S. Floyd College of Medicine dDepartment of Health Policy Administration, Elson S. Floyd College of Medicine ePrevention Science fCollege of Nursing gDepartment of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Washington, USA Received 19 November 2019 Accepted as revised 16 April 2020 Correspondence to Crystal Lederhos Smith, PhD, Health Policy Administration, Elson S. Floyd College of Medicine, PO Box 1495, Washington State University, Spokane, WA 99210-1495, USA, Tel: +509 368 6876; fax: +509 358 7505; e-mail: email@example.com Behavioural Pharmacology: October 2020 - Volume 31 - Issue 7 - p 702-705 doi: 10.1097/FBP.0000000000000568 Buy Metrics Abstract This study examined associations between drinking and smoking prior to treatment (biochemically measured at baseline), alcohol and tobacco craving, and biochemical alcohol and tobacco use during the analog trial period. We conducted a secondary data analysis of a randomized clinical analog trial where participants with a Diagnostic and Statistical Manual, Fourth Edition Text Revision (DSM-IV-TR) diagnosis of alcohol dependence, abuse or reported heavy drinking, with a co-occurring DSM-IV-TR diagnosis of nicotine dependence, abuse or reported heavy use, who were not seeking treatment were recruited. A generalized estimation equation model for longitudinal binary outcomes was created (N = 34) to determine the predictive effects of baseline tobacco use, alcohol craving, and tobacco craving on alcohol use over the 4 weeks of the trial. Baseline smoking was significantly (*p < 0.05) associated with drinking over time [odds ratio (OR) = 3.09*], while baseline drinking was associated with smoking (OR = 4.17*). Baseline alcohol and tobacco craving were positively associated with smoking over time (OR = 3.21* and OR = 1.92*, respectively) but were negatively associated with alcohol use over time (OR = 0.79* and OR = 0.57*, respectively). Heavier use of either tobacco or alcohol preceding treatment may require more intensive interventions in order to reduce tobacco and alcohol use. Future trials designed to address mechanisms of behavior change in the context of novel treatments could promote a better understanding of the cross-rewarding effects related to the co-use of these substances and lead to the development of more integrated and appropriately intense treatments for individuals with concomitant tobacco and alcohol use disorders. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.