Behavioral/Drug Therapy for Alcohol-Nicotine Dependence (Naltrexone/Nicotine Patch)

Inclusion Criteria: * Meets criteria for alcohol and nicotine dependence. * Individuals will be outpatients with alcohol and nicotine dependence who have completed detoxification (medicated or nonmedicated) within the past 48-120 hours. * Smoking no less than 10 cigarettes/day and no greater than 50 cigarettes/day. * Motivated to quit smoking. * Willing and able to participate in the 12 week outpatient treatment. * Acceptable health. * Able to provide a collateral informant. * Willing to be followed for 6 months after treatment ends. * Willing and able to provide the names of three family members or friends to aid in locating participants for follow-up. Exclusion Criteria: * Current diagnosis of dependence on other substances except nicotine and alcohol. * Having moderately severe or severe alcohol withdrawal symptoms. * Recent (less than 48 hours) evidence of hazardous drinking (more than 2 drinks/day for females; 3 drinks/day for males). * History of opioid abuse. * Recent use of cocaine. * Not desiring to quit smoking. * Recent past or current pharmacotherapy involving naltrexone or transdermal nicotine systems. * History of psychosis. * Current suicidality, homicidally or psychiatric symptoms requiring other medications. * Presence of medical abnormalities that contraindicate naltrexone or nicotine replacement therapy. * Current treatment with psychotropic medications. * Pregnancy or nursing for female patients. Inability or unwillingness to participate in the 12-week outpatient treatment.