Should Addicts in Treatment Stop Smoking?

Drugs, alcohol and smoking often go hand in hand. While cigarettes are legal and the consequences may not be as dire as the effects of alcoholism or drug abuse, smoking is still a serious addiction. Illness, suffering and premature death caused by use of nicotine are well documented.

Studies conducted by SAMHSA (the Substance Abuse and Mental Health Services Administration) indicate that more than 60 percent of people with substance abuse disorders are tobacco users, compared to about 28 percent of the general population. Research also indicates that drug and alcohol users tend to be heavier smokers. Thus, risk of severe chronic conditions such as asthma, heart and lung problems, cancer, a shortened lifespan and ultimately, an earlier death are associated with nicotine use and thus pose a greater risk for addicted people.

The Controversy

In light of these frightening "statistics", it may seem obvious that smoking cessation should be incorporated into drug and alcohol treatment and rehab, and in the past, stopping smoking was sometimes a condition of treatment. However, the answer isn’t that simple and there are valid arguments both for and against.

Is Quitting During Treatment Always A Good Idea?

Quitting smoking during drug and alcohol treatment isn’t always beneficial and many treatment providers argue against the idea. Why? Allowing smoking to continue may seem counter-intuitive, but people in treatment for drug or alcohol addiction have a difficult road ahead. The concern is that the extra stress involved in fighting a secondary addiction may be overwhelming enough to derail treatment entirely.

The need to stop isn’t ignored or swept under the carpet, but smokers are often advised to tackle the nicotine habit after they have been established in recovery for at least a full year.

On the flip side, NIDA (The National Institute for Drug Addiction) argues that treating smoking doesn’t negatively affect treatment and in fact, may actually improve treatment outcomes for drug and alcohol addiction, possibly because severing the close connection between smoking and drugs makes it easier to give up both.

Like any other addiction, smoking is a way of escaping life’s challenges. Some treatment professionals argue that smoking can trigger cravings, and that continuing to smoke after treatment may significantly increase the risk of relapse.

Readiness and other Factors

Some individuals may be ready to make healthy choices, and giving up smoking for good is always the ultimate goal. However, for clients who aren’t yet willing or able to stop, even cutting back can be a positive achievement that can improve health considerably.

In our view, every situation must be assessed realistically on an individual basis, and smokers should never be coerced to quit or made to feel guilty. Considerations include each client’s wishes, expectations for treatment, and their desire and readiness to quit. Other factors involve smoking history and severity of nicotine dependence.

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