New research suggests that your hangover will be worse if you smoke when you drink.

People who smoke on a day when they have been drinking alcohol heavily are twice as likely to report hangover symptoms as those who only drank. In the study of college students, heavy drinking was defined as about five or six cans of beer in one hour.

But substance abuse experts not affiliated with study are quick to point out that binge drinking and smoking -- alone and together -- can have far worse consequences than hangover symptoms. Smoking increases the risk for cancer, heart disease, and stroke, and binge drinking can lead to addiction, alcohol poisoning, car accidents, and unprotected sex.

“In general, people smoke more when they drink because it counteracts some of the sedative effects of alcohol,” says researcher Damaris J. Rohsenow, PhD. She is a professor of behavioral and social sciences at the Center for Alcohol and Addiction Studies at Brown University in Providence, R.I.

“People also tend to feel better when they smoke while drinking because both increase the release of [the brain chemical] dopamine.” Dopamine is known as the brain’s pleasure chemical.

The findings appear in the Journal of Studies on Alcohol and Drugs.

A Bad Combination

Exactly how smoking makes a hangover worse is not fully understood. Both alcohol and smoking can disrupt sleep, which may make hangovers feel a lot worse, Rohsenow says. What's more, the dopamine rush may also be followed by a shortfall of this brain chemical.

The study included 113 college students from a Midwestern university. They answered an online survey daily for eight weeks. Questions concerned how much they drank or smoked on the day before as well as their current-day hangover symptoms.

According to the findings, students smoked about seven cigarettes a day, and this number jumped to more than 10 on heavy or binge-drinking days. Students reported drinking an average of more than two drinks a day, and more than 10 on average on heavy drinking days.

“The best way to avoid a hangover is not to drink that much, but if you smoke, it will aggravate it, so this provides another reason to not smoke,” she says.

Binge Drinking Is Risky Business

Cory Trevena is the student assistance program coordinator at Caron Treatment Centers in Wernersville, Pa.  “Using cigarettes while drinking certainly could add to the hangover effect,” she says. But binge drinking is prevalent on many college campuses and has more serious consequences than a worsened hangover.

“The focus should not be on the short-term hangover, but on the likelihood of developing addiction and other harmful consequences,” she says.

Patrician Hincken agrees. She is the director of addiction recovery services at Zucker Hillside Hospital in Glen Oaks, N.Y. “Having a hangover is connected to binge drinking, which we know is extremely risky to begin with,” she says.

Hangovers are red flags that you drank too much. They should not be considered normal. Getting drunk with friends is not social drinking. “Social drinking is having one or two drinks while out with friends,” Hincken says.

SOURCES: Jackson, K. Journal of Studies on Alcohol and Drugs, January 2013.Damaris J. Rohsenow, Ph.D, professor of behavioral and social sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, R.I.Patricia Hincken, director of addiction recovery services, Zucker Hillside Hospital in Glen Oaks, N.Y.Cory Trevena, student assistance program coordinator, Caron Treatment Centers, Wernersville, Pa.

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