The Risks of Associated Use of Alcohool and Tabaco: A Functional Learning and Its Limits

Drinking alcohol and smoking tobacco commonly occur together. Young adults, middleaged adults, elderly people, and very elderly people perceive the combined effects on health of drinking and smoking as sub-additive. This model bears little resemblance to what is expected on the basis of epidemiological studies. The health risks of combining drinking and smoking, particularly the risk of cancer is multiplicative. This article reviews studies showing that learning the multiplicative relationship between daily intakes of alcohol and tobacco, and the risk of esophageal cancer is effective, even in 75 aged people, provided that participants receive outcome feedback through functional learning. This learning persists at least one month. This learning has limitations due to the decline of executive functioning that is associated with aging. The very old people have difficulty in learning the multiplicative rule. Instead, they learn an additive rule. Other studies are required. Because of the nature of the risks for esophageal cancer, specific groups should be targeted, those who drink and smoke heavily, and for whom esophageal cancer looms as an important personal threat.