Should Cigarette Smoking be Addressed in Treatment for Addiction?

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Integrating tobacco dependence treatment across substance abuse programs can improve overall health services for those wishing to recover. Addressing an individual’s smoking while in treatment provides various benefits that can reduce the long-term negative consequences of continued use in recovery. When an individual continues smoking in recovery, this puts both their recovery and health at risk. 

According to the Centers for Disease Control and Prevention (CDC), cigarette smoking is the leading cause of preventable disease and death in the United States, killing more than 480,000 Americans each year. Despite this, many people believe that smokers should not quit while seeking treatment for substance use or mental health disorders because it might interfere with their recovery. While it is essential that individuals give up the substance they seek treatment for, and this should take precedence, the long-term effects of cigarette smoking can be severe and should not be ignored.

Drawbacks to Smoking in Recovery

Concerning substance abuse and mental health problems, some people may continue to smoke tobacco in recovery to give themselves a boost in mood as nicotine is a stimulant and mood enhancer. When this is the case, it may be even more difficult for these people to quit as they use smoking as a coping mechanism to alleviate negative or depressive moods. Another reason may be that they are uncertain about giving up smoking, worrying that it will interfere with their abstinence from other drugs. However, instead of developing healthy coping skills, they may rely on smoking to cope. This may lead to unhealthy coping mechanisms in recovery where individuals smoke cigarettes to relieve cravings from another drug but remain dependent on nicotine.

According to the National Institute on Drug Abuse (NIDA), about 65% to 85% of people in treatment for a substance use disorder (SUD) smoke cigarettes. While smoking cigarettes is common among those in treatment and recovery, there are many drawbacks to continued smoking in addiction treatment. According to NIDA, the following should be considered when an individual seeking treatment is also a cigarette smoker:

  • Cigarette smoking increases the likelihood of relapse among people in recovery from SUD.
  • Cigarette smoking often accompanies other drug or alcohol use and may serve as a relapse trigger.
  • Some studies have linked nicotine to cravings for stimulants and opioids.
  • Smoking cigarettes has long-term detrimental effects on health and raises the risk of developing other diseases, such as cancer.

Benefits of Quitting Smoking in Recovery

Helping patients quit and remain abstinent from cigarette smoking can help improve their chances of long-term recovery. The barrier to fully integrating smoking cessation into some substance abuse programs arises from the belief that quitting smoking would be too much for an individual to undertake while stopping another substance. Some clinicians may believe that it will cause clients to destabilize, causing relapse. This perception that cigarette smoking helps clients remain abstinent from other drugs and alcohol has fostered the culture of continued smoking among those in recovery. However, even though various substances have different mechanisms, all commonly abused drugs affect the same reward circuit in the brain. Ultimately, patients may do better if programs also address smoking while in treatment for their SUD. 

The benefits of quitting smoking while in recovery include:

  • Improving overall health and reducing the likelihood of long-term health consequences, such as cancer or heart disease.
  • Improving treatment outcomes and helping sustain recovery.
  • The availability of treatment and guidance for tobacco addiction.

Recognizing and Building Motivation to Quit

While there may be a perception that clients receiving SUD treatment are uninterested in quitting smoking, this may not be the case. A significant portion of people may be interested in stopping using all addictive substances and take advantage of being in a treatment facility for just that. Tobacco and all substances that are abused can have negative health consequences, and the goals of recovery align with deciding not to be dependent on any unhealthy substance as a coping mechanism.  

Therefore, it is essential to recognize when a client is interested in quitting smoking and building motivation to quit. Because tobacco is a drug that can lead to dangerous health consequences, many may be open to quitting smoking while receiving treatment. Abstinence from all drugs of abuse or dependence can help them move into a more clear, healthier psychological, mental, and physical state. 

Nonetheless, there may also be smokers receiving SUD treatment who are not interested in quitting while in the program. It is critical to recognize this and provide them with information on the potential benefits to quitting and treatment outcomes. Motivational interventions and therapies can also help clients come to their own realization about this as well. 

While some people may believe it is too difficult or risky to give up smoking cigarettes and other addictive substances simultaneously while in treatment, there may be significant benefits to addressing smoking cessation during treatment. These benefits include improving overall health and reducing the likelihood of long-term health consequences, such as cancer or heart disease, and improving treatment outcomes and long-term recovery. Cigarette smoking can increase the likelihood of relapse among people in recovery from SUD, and cigarette smoking often accompanies other drug or alcohol use that may serve as a relapse trigger. Therefore, quitting smoking is critical for improving the health and wellbeing of persons in treatment for or in recovery from alcohol abuse and other substance use disorders. At Alta Centers of Los Angeles, California, we provide premier substance abuse treatment to those ready to take the life-affirming step of getting and remaining sober. Reach out to us at (888) 202-2583.

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