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.