It’s no secret that cigarettes and alcohol go together like peanut butter and jelly for some people, but what about electronic cigarettes? After all, they were developed to mimic traditional cigarettes in look, feel, and experience. A recent study conducted by researchers from Indiana University-Purdue University has found that, similar to real cigarettes, e-cigarettes go hand in hand with drinking and can actually lead to more problematic drinking.

"This area of research is extremely important and I don't want it to get pushed to the side," said Alexandra Hershberger, lead author of the study, in a statement. "Establishing the direct health effects of e-cigarette use is important, but it's vital to look at the secondary effects too."

Hershberger and her colleagues surveyed over 1,400 respondents using a modified version of the Nicotine and Other Substances Interaction Expectancy Questionnaire (NOSIE). Participants who reported alcohol use were split into two groups and asked if they expected to use alcohol and e-cigarettes together. While over 6 percent of the general population reports using e-cigarettes, around 17 percent of people dealing with addiction report doing so.

Among participants in both groups, those who drank were likely to start using e-cigarettes and those use e-cigarettes likely to start drinking. People who reported e-cigarette use prior to the start of the study were more likely to start drinking problematically compared to non-users. Anyone who expected to use alcohol and e-cigarettes together started drinking more by the end of the study.

"If you quit smoking cold turkey, it affects other behaviors associated with smoking, such as drinking," said Alexandra. "By replacing smoking with e-cigarette use, it could be that you're at risk of continuing behaviors you don't want to continue. This is particularly serious for people with alcohol addiction — using e-cigarettes could make it harder to stop drinking."

Findings from the study show that e-cigarettes may not be best for experiencing some of the benefits of smoking cessation. People who quit smoking also reported drinking less. If smokers drop traditional cigarettes for e-cigarettes then they may continue to drink or, in some cases, drink more.

"We were surprised to see higher e-cigarette use in women," Alexandra added. "Generally men tend to report more risk-taking across the board, but in our study, women outnumbered men in terms of e-cigarette use. This could be because women perceive the device differently to other risk-taking behavior; e-cigarettes tend to be viewed more positively than cigarettes. Those views could be driving more use in women than we'd expect."

If you’ve ever wondered what it is about cigarettes and alcohol that make them so enjoyable together, a similar study conducted by researchers from the Baylor College of Medicine found that cigarettes are enticing to some people when they’re drunk due to stress hormones and the effect they have on the brain’s pleasure center. Results showed that as alcohol boosts dopamine levels in the brain, including feelings of elation, and users would often attempt to reach prior levels of enjoyment by lighting up a cigarette.

Source: Cyders M, VanderVeen D, Karyadi K, Hershberger A. Combined expectancies of alcohol and e-cigarette use relate to higher alcohol use. Addictive Behaviors. 2015.