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William R. True, PhD, MPH; Hong Xian, PhD; Jeffrey F. Scherrer, MA; Pamela A. F. Madden, PhD; Kathleen K. Bucholz, PhD; Andrew C. Heath, DPhil; Seth A. Eisen, MD, MSc; Michael J. Lyons, PhD; Jack Goldberg, PhD; Ming Tsuang, MD, PhD, DSc

Arch Gen Psychiatry. 1999;56:655-661.

Background  Nicotine and alcohol dependence often occur together. We examined data from male twin pairs to determine whether there are genetic or environmental influences common to nicotine and alcohol dependence, and, if so, to estimate the magnitude and correlation of these influences.

Methods  Subjects were 3356 male-male twin-pair members of the Vietnam Era Twin Registry who participated in a 1992 telephone administration of the Diagnostic Interview Schedule Version 3 Revised. Genetic model fitting was performed to estimate the magnitude and correlation of genetic and environmental contributions to lifetime nicotine and alcohol dependence.

Results  The heritability of nicotine dependence was 60.3% (95% confidence interval [CI], 55.4%-65.2%); that of alcohol dependence, 55.1% (95% CI, 49.7%-60.5%). The best-fitting model for the co-occurrence of lifetime nicotine and alcohol dependence included a substantial genetic correlation between both disorders (r=0.68; 95% CI, 0.61-0.74) and a modest unique environmental correlation (r=0.23; 95% CI, 0.14-0.32).

Conclusions  These data suggest a common genetic vulnerability to nicotine and alcohol dependence in men. This common genetic influence may partially explain the clinical and epidemiological observations that alcoholics are often dependent smokers.

From the School of Public Health, St Louis University Health Sciences Center (Dr True and Mr Scherrer), Research Service (Drs True, Xian, and Eisen and Mr Scherrer) and Medical Service (Dr Eisen), St Louis Veterans Affairs Medical Center, and the Departments of Psychiatry (Drs Madden, Bucholz, and Heath), Psychology and Genetics (Dr Heath), and Internal Medicine, Division of General Medical Sciences (Drs Xian and Eisen), Washington University School of Medicine, St Louis, Mo; the Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center (Drs Lyons and Tsuang), the Department of Psychology, Boston University (Dr Lyons), and the Harvard Institute of Psychiatric Epidemiology and Genetics (Dr Tsuang), Boston, Mass; the Department of Veterans Affairs, Health Services Research and Development, Cooperative Studies in Health Services, Hines, Ill (Dr Goldberg); and the Epidemiology Program, School of Public Health, University of Illinois, Chicago (Dr Goldberg).

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