Purpose: No clinical evidence-based data on a possible negative influence of osteopenia and harmful lifestyles on implant osseointegration have been published to date. However, chronic alcohol abuse has been related to a progressive osteoporotic state. The continuous effort on developing better performing surfaces might offer improvement in osseointegration rates in conditions of poor bone quality. The aim of the present study was to investigate, in vitro, the behavior of osteoblasts obtained from rats exposed to ethanol vapor for 7 weeks and cultured on an innovative titanium surface achieved by a double anodic spark deposition. Materials and Methods: Ethanol-exposed and unexposed (control) osteoblasts were cultured on an anodic spark-deposited titanium surface and compared to those cultured on an acid-etched one. Cell proliferation and synthesis of alkaline phosphatase, osteocalcin, collagen I, transforming growth factor-β1, interleukin-6, and tumor necrosis factor-α were measured at 3, 7, and 14 days of culture. Results: When cultured on the anodic spark-deposited titanium surface, ethanol-exposed osteoblasts recovered proliferation impairment. Anodic spark-deposited titanium surfaces significantly improved both ethanol-exposed and unexposed osteoblast bioactivity, particularly with regard to alkaline phosphatase and transforming growth factor-β1. Moreover, interleukin-6 release for ethanol-exposed osteoblasts was significantly reduced by the anodic spark-deposited titanium surface. Conclusion: Proliferative and synthetic cell processes altered by ethanol contact were positively and partially restored by contact with the tested innovative surface.