Biological Processes Underlying Co-Use of Alcohol and Nicotine: Neuronal Mechanisms, Crosstolerance, and Genetic Factors

Alcohol and nicotine are two of the oldest and most commonly used recreational drugs, and many people use both of them together. Although their ready availability likely contributes to the strong correlation between alcohol and nicotine use, several lines of evidence suggest that biological factors play a role as well. For example, both alcohol and nicotine act on a brain system called the mesolimbic dopamine system, which mediates the rewarding and reinforcing properties of both drugs. Modification of the activities of the mesolimbic dopamine system can interfere with the effects of both alcohol and nicotine. Another mechanism that may contribute to alcohol–nicotine interactions is cross-tolerance to the effects of both drugs. Finally, genetic studies in humans and of selectively bred mouse and rat strains suggest that shared genetic factors help determine a person’s liability to use or abuse both alcohol and nicotine.