Alcohol dependence exists on a continuum of severity and is defined as a “craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences” and associated with an increased rate of mental and physical disorders.9 There are over 600,000 people estimated to have alcohol dependence in England,10 though only a minority access treatment,9,11 and of these, 40% were receiving treatment for alcohol alongside other substances (e.g. opiate, cannabis).12 There is a strong shared association between smoking and drinking13 with people who are more dependent on alcohol also being more dependent and heavier smokers.14 Alcohol consumption is a known predictor of smoking relapse among people who are heavy drinkers,15 and higher levels of alcohol consumption can make quitting smoking more difficult.16 However, despite this shared association and a high desire to quit smoking,6 those receiving alcohol treatment are less likely to have their smoking addressed.4,6,7
