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John P. Pierce, PhD; Ronald M. Davis, MD
Centers for Disease Control Rockville, Md

Michael C. Fiore, MD, MPH
University of Wisconsin Madison

JAMA. 1989;261(18):2634-2635.

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In Reply.—

Dr DiFranza and Ms Guerrera imply that we expect the decline in the prevalence of smoking in the United States to slow down because there exists a group of hard-core smokers who are unwilling or unable to quit. They claim that any such group must be alcoholics and predict that the prevalence of alcoholism among smokers will increase from 17% to 25% by the year 2000.

The association between alcoholism and smoking is well known, but we suspect that Dr DiFranza and Ms Guerrera's calculations overestimate the current (and future) prevalence of alcoholics among smokers. First, they apply smoking prevalence figures and quit ratios among hospitalized alcoholics¹ to population-based data on prevalence of alcoholism. Smoking prevalence may be considerably higher among alcoholics undergoing treatment compared with persons classified as alcoholic in population-based surveys. They also assume no decline in smoking uptake in people who will later be . . . [Full Text PDF of this Article]

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