Smoke Signals: Why Are Cigarettes Such a Hot Commodity in Treatment?

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Years ago, while I was in a nine-month substance abuse treatment program, I realized that everyone around me had one thing in common – they smoked.

In fact, their lives seemed to revolve around the next cigarette, so much so that they weren’t putting their focus on where it should have been: on their sobriety.

Could Smoking Negatively Affect Recovery?

As it turns out, people in rehab have higher rates of cigarette use than the rest of the general population. And according to two recent studies, these higher rates negatively affect substance abuse treatment success.

Let’s take a look at those studies now:

  • Study #1This research, led by Barbara K. Campbell, Ph.D. a clinical psychologist and associate professor at Oregon Health & Science University, discovered smoking rates among those in treatment facilities continue to be high, despite significant national declines in nicotine use. In the United States, for example, 40 percent of the population smoked in 1965, while only 17.8 percent reported smoking by 2013.

    “Although smoking rates have declined substantially in the general population, they remain very high among people with other addictions,” Campbell said. “This increases disease burden and mortality and may contribute to difficulty maintaining abstinence from other drugs.”

    Among the 1,113 participants surveyed, 159 (14.3 percent) smoked before treatment, and 87 (7.8 percent) were non-smokers before rehab. However, a whopping 867 (77.9 percent) of them reported smoking an average of 10 cigarettes a day upon completion of their stay in rehab.

  • Study #2Researchers at Vanderbilt University found that, out of the one million Americans in Alcoholics Anonymous (AA), approximately 56.9 percent were smokers. Among this group of smokers, 78.7 percent smoked at least half a pack a day and more than 60 percent considered themselves highly dependent on cigarettes.

The Bottom Line: Smoking is Bad For You

These results should cause an increase in concern, considering smoking led the participants to feel less depressed, anxious, and irritable – all feelings more likely to contribute to a return to substance use. Knowing that, researchers believe the reliance on cigarettes by people in recovery has a biological basis and may actually increase the chances of relapse.

So, how can the prevalence of smoking be reduced by those in recovery? Researchers emphasized the need for targeted efforts and individualized attention against smoking.

“Clients in substance use disorders treatment were more likely to quit smoking if it was part of their individualized treatment plan,” Campbell said. “People in these groups often want to quit smoking but face many barriers in doing so. Incorporating smoking cessation interventions into drug treatment is an important step.”

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