Chronic, heavy drinking has been found to harm the brain; the study examined the added effects of smoking on alcohol-dependent individuals. About 80 percent of chronic drinkers involved in the study said they smoked regularly.

For the study, magnetic resonance spectroscopic imaging was used to measure common brain metabolites in 24 drinkers who were in treatment and 26 light drinkers. Of the individuals in treatment, 14 were smokers. Among light drinkers, 7 smoked.

"While the effects of cigarette smoking on the heart, lungs, central and peripheral vascular systems, and its carcinogenic properties have been studied for many years in humans, very little is known about its effects on the brain and its functions," said Timothy Durazzo, a neuropsychologist and neuroscience researcher at the San Francisco Veterans Administration Medical Center and corresponding author for the study. "A mere handful of studies indicate that chronic cigarette smoking by itself has adverse effects on brain structure and cognitive functioning. However, to date, we are not aware of any published studies using magnetic resonance imaging the brain damage found in alcoholics in treatment is entirely from chronic excessive alcohol consumption or from being smokers, as well."

"Results indicate that chronic cigarette smoking increases the severity of brain damage associated with alcohol dependence," continued Durazzo. "That is, the combined effects of alcohol dependence and chronic smoking are associated with greater regional brain damage than chronic alcoholic drinking or smoking alone. Our studies show that this exacerbation of the alcohol-induced brain damage is most prominent in the frontal lobes of individuals studied early in treatment."

Durazzo said the damage to the brain's frontal lobes could compromise the success of treatment and recovery. That part of the brain is responsible for multiple functions of everyday life, including a person's ability to accurately judge or anticipate the consequences of their actions.

The study found that cigarette smoking alone caused damage to neuronal viability and cell membranes in the midbrain and on cell membranes of the cerebellar vermis.

"These brain regions are involved in fine and gross motor functions and balance and coordination," said Durazzo. "We also observed that higher smoking severity among smoking recovering alcoholics was associated with lower N-acetylaspartate levels in lenticular nuclei and thalamus, areas also involved in motor functions."

The study's findings are published in the December 2004 issue of Alcoholism: Clinical & Experimental Research.

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