Smoking Cessation in Alcoholism Treatment

Inclusion Criteria: Meets criteria for alcohol dependence within the past three months, and criteria for nicotine dependence. Smoking at least 10 or more cigarettes per day for the past year. Seeking treatment for both alcohol and nicotine dependence. Minimum 1 week of alcohol abstinence and substance abuse day treatment attendance. Willing to provide names of two individuals who can help locate the subject at follow-up. Willing to provide name of one individual who can provide collateral information about alcohol and tobacco use. Exclusion Criteria: Other substance use disorder meeting criteria for dependence. Acute medical or psychiatric disorder requiring inpatient treatment. Taking medications known to influence alcohol urges (naltrexone, disulfiram). Medical problems that would contraindicate nicotine patch use. Allergy or hypersensitivity to nicotine or to adhesives used in transdermal delivery systems. Use of other nicotine products such as cigars, pipes, or smokeless tobacco. Severe generalized skin disorder. Myocardial infarction within 3 months prior to study entry. Unstable angina. Pregnant or lactating females, or females who are not practicing a medically accepted form of contraception. Impaired vision or hearing which would interfere with using a hand-held computer. Reading ability below fifth grade level. Lack of reliable transportation to the treatment site, or living more than 1 hour from treatment site. Homeless or unstable residence. Plan for future admission to residential treatment.