Alcohol and nicotine are substances often consumed simultaneously for their additive, and for some, synergistic effects that they can have on one’s perceptions and inhibitions. A significant portion of university students drink alcohol regularly, and an often-uttered phrase around campus environments is, “I only smoke when I drink”, in reference to the concomitant consumption of tobacco/nicotine-containing products. Previous research characterizing this combination in college student is very limited; this two-part study sought to develop a measure to understand the motives behind combining alcohol and nicotine (ALCNIC) in college students in the United States. The first part of the study involved recruiting a sample of students reporting ALCNIC use from a large northeastern university (N=55, 57.1% female, 92.9% white) as well as a smaller focus group at the university (N=22, 77.3% female, 90.9% white) in order to extrapolate and confirm motivations for the behavior. The motivations were divided into four categories: antagonistic (consuming nicotine to compensate for alcohol’s effects), synergistic (pleasure derived from the simultaneous use of the two substances), social (“fitting in” with the social environment), and negative effects (“anxiety” surrounding ALCNIC). The researchers developed a 24-item survey containing questions related to these motives, which was answered by the study’s participants on a 5-point scale (ALCNIC Motives Scale, or ANMS). Example questions, both positive and negative, include “How often would you say that you combined alcohol and nicotine to avoid falling asleep?”, or “How often would you say that you avoided combining alcohol and nicotine because you will not sleep well?” Confirmatory factor analysis was used to validate the consistency of the items and scaling within the survey. The second part of this study recruited college students across the nation (N=5899), via an online tool called Amazon Mechanical Turk, with subsequent education status verified to avoid improper sampling. After implementing eligibility criteria related to the participants’ ALCNIC history, a final sample of 336 students (N=336, 49.7% female, 72.9% white) consented and responded to the originally developed survey. Similar factor analysis was conducted on this survey to confirm measure validity. The results of this survey found significant associations for ALCNIC use with the synergistic factor as well as the negative effects factor. No relationship was found to exist for ALCNIC use with the antagonistic factor or the social factor. The authors note that these findings seem to indicate that college students’ consumption of ALCNIC is either positively motivated by the synergistic effects that the combination elicits or is negatively associated due to students wanting to avoid the negative effects of the combination.
Takeaway: The demand for research concerning ALCNIC consumption in college students is high, and this initial study found two important motivating factors behind the behavior by producing and using the ALCNIC Motives Scale. Additional research is needed to further develop these findings.