Almost half of the drop is attributable to lifestyle changes, especially smoking and diet, it suggests.

The research team used a combination of published data on the use and effectiveness of specific treatments for heart disease and associated risk factors, such as smoking, cholesterol, high blood pressure, obesity, diabetes, and a sedentary lifestyle.

Between 1985 and 2000, deaths from coronary artery disease in Ireland fell by 47% in those aged 25 to 84, resulting in almost 3800 fewer deaths in 2000 than in 1985.

Almost 44% of the drop-off was attributable to better, and more timely, treatment, including tackling heart failure and secondary prevention.

But just under half of the figure (48%) was attributable to sharp falls in smoking, which accounted for over 25%, and in cholesterol, which accounted for 30%. Falls in high blood pressure accounted for 6%.

Smoking rates have fallen more slowly in Ireland than they have in the UK and other developed countries, but have been given a boost by a ban on workplace smoking, which came into force in 2004.

Rises in rates of obesity, diabetes, and sedentary lifestyles offset these favourable trends by around 13% or 500 deaths. And the authors suggest that if these trends continue, they threaten to overturn the substantial health gains made.

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"This may be a lot to ask from an alcoholic individual going through drastic brain chemical imbalances in early recovery," he acknowledges. "But it may lead to faster brain recovery."

Durazzo points out that while severe, such a strategy might be effective because among alcoholics, "cigarettes and alcohol tend to go together. One may elicit cravings for the other. So if you are able to give up both at the same time, it may increase your chances of staying sober, because you don't have one substance serving as a trigger for use of the other."

Durazzo says the study also raises the question of whether smokers respond differently than nonsmokers to current pharmacological treatments for alcoholism: "Do these alterations in brain chemistry have implications for pharmacological treatments of both smoking and alcohol abuse? That remains to be seen."

For their next step, Meyerhoff, Durazzo, and their research team plan to analyze their study participants' brain chemistry and neurocognitive performance after six months of sobriety, which they hope will give insight into differences in long-term recovery between the two populations.

The researchers also plan to study an entirely different group of smoking and nonsmoking recovering alcoholics. That study will look at whether other health factors, including diet, exercise, and general health, affect the brain's recovery from alcohol abuse.

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