Tobacco, alcohol, and caffeine use: A review of their interrelationships

Reviews observational and survey studies on the simultaneous use of 2 or more of the following substances: tobacco, alcohol, or caffeine. Evidence to date indicates that, among each of the 3 possible pairs of relationships of these 3 substances, alcohol and tobacco use and tobacco and caffeine use are moderately to strongly related, and caffeine and alcohol use weakly related. These studies included the use of tobacco and alcohol by adolescents and the use of cigarettes by alcoholics. No studies examined the concurrent use of all 3 substances. The need for improved methods of assessing substance use and research examining health-risk behaviors as interrelated clusters is emphasized, and mechanisms that might account for these interrelationships are discussed. Although there are no general theoretical models that adequately account for these interrelationships, the role of several specific pharmacological or behavioral mechanisms as well as generalized individual difference factors may be postulated. (89 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).