The influence of smoking cigarettes on the high and desire for cocaine among active cocaine users

The primary aim was to evaluate whether nicotine use alters the high or desire for cocaine among active cocaine users who concurrently smoke cigarettes. Participants answered the Fagerstrom Test for Nicotine Dependence (FTND), Nicotine-Stimulant Interaction Questionnaire (NSIQ), and Multiple Drug Use Questionnaire (MDUQ). These questionnaires employ subject recall of participants' drug use habits. The participants that smoked (N = 163/188) were primarily African American males who were 45.0 ± 0.5 (mean ± S.E.M.) years of age, and used cocaine for 17.9 ± 0.6 years and 19.8 ± 0.6 days out of the last 30. These individuals smoked 14.0 ± 0.8 cigarettes/day (CPD), scored 4.6 ± 0.2 (on a scale of 0-10) on the FTND, and smoked cigarettes for 23.5 ± 0.7 years. Two questions from the MDUQ, which evaluates the interaction between cocaine and nicotine, (− 5: reduces effect, 0: no change, + 5: increases effect) included “Does nicotine affect the high that you experience from cocaine?” and “Does nicotine affect your desire for cocaine?”, and the scores were 1.3 ± 0.2 and 0.8 ± 0.2, respectively. The NSIQ also evaluated interactive effects of nicotine and cocaine, on a scale of 0 to 100 (0: not at all, 100: most ever). Smokers responded most strongly that using cocaine increased both the urge to smoke and cigarette craving. Additional analyses were performed by separating participants into HighCPD vs. LowCPD groups via median split. The HighCPD group smoked 22.7 ± 1.1 CPD while the LowCPD group smoked 6.4 ± 0.3 CPD [F(1,161) = 228.4, p < 0.0001], and the HighCPD group had a mean FTND score twice that of the LowCPD group. Significant differences emerged between the two groups on multiple items of the NSIQ, but not the MDUQ. The subjective ratings of high and desire for cocaine, and several subjective effects produced by cocaine, were modestly altered by cigarette smoking. Taken together, these data suggest that cigarette smoking may augment the craving and high produced by cocaine.