A preponderance of available data indicates that you shouldn’t smoke while in rehab for substance use disorders (SUDs). In recent years, several studies have demonstrated a link between smoking and undesirable outcomes for drug or alcohol addiction. It so happens that a lot of people with SUDs are also smokers.
To be fair, industrial tobacco represents its own substance use disorder (SUD), comorbid with alcohol, opioid or stimulant use disorders, for example. Conversely, many people enrolled in addiction treatment programs feel that quitting smoking while also learning how to quit drugs or alcohol is just too overwhelming. As such, a myth has developed that quitting multiple substances increases the likelihood of relapse.
What Does Data Actually Say About Cigarette Smoking and Addiction Recovery?
The National Institute on Drug Abuse (NIDA) has interpreted the data from one significant study as linking cigarette use to relapse for those in recovery from SUDs. The research in question comes from a study published in 2017. Dr. Andrea Weinberger of Yeshiva University co-led the study with Dr. Renee Goodwin of City University of New York. Several colleagues of theirs contributed to the work also.
They analyzed 5,515 people’s responses to the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). That survey was administered from 2001-2002 and again from 2004-2005. The team looked at the results of both iterations of the survey. All the respondents were people who had a history of SUD. They were all also considered to be in remission; in other words, they weren’t active substance users.
This research team found that those who smoked cigarettes at the time of their initial interview for the survey as well as those still smoking three years later were all approximately 1.5 times more likely to use drugs or alcohol. They were also twice as likely to have diagnosable SUDs at their follow-up interview than those who’d quit smoking.
Moreover, those who already weren’t smoking cigarettes by the time of the initial interview were analyzed. Some of them started smoking between interviews. Those who did were found to be five times more likely to report substance use at the follow-up interview compared to those who didn’t smoke at all.
Other Studies Find Similar Results About Relapse
In 2019 – two years after the Weinberger study – another research team investigated a related query with a different methodology. The report took it as a given that cigarette smoking correlates with adverse outcomes in addiction recovery. The point of the study was actually to compare cigarette smokers with a history of SUD to smokers without a SUD history. The researchers wanted to determine whether or not those with past SUDs relapsed on tobacco more or less often than those without.
“The prevalence of cigarette smoking among individuals with a history of substance use disorders (SUDs) remains up to four times higher than those without a history of SUDs,” the report reads. “More than half of individuals who attain sustained remission from SUDs will die of tobacco-related diseases.”
Lead researcher Dr. Amanda Quisenberry and four others collaborated with the same Dr. Goodwin from the Weinberger study. They randomized participants in six sessions of multicomponent cognitive behavioral therapy (CBT) and eight weeks of nicotine patches, and then followed them each for six months at a time. To even participate, each member of the cohort had to pass a urine-based toxicity screening test. Relapse was defined as any cigarette smoking within a seven-day period, so “in recovery” was determined to be seven days and counting without tobacco use.
The study found smokers in recovery from SUDs to be up to twice as likely to relapse than those without a SUD history. Extant data suggested those who did relapse on cigarettes were also more likely to die of tobacco-related diseases even if they did beat other SUDs. In other words, tobacco is highly likely to rob you of your victory against another substance later in life.
Is It Unrealistic to Fight Two Addictions at Once?
NIDA also interprets the Weinberger study as indicating that helping patients quit cigarette smoking
might actually improve their odds of success in addiction recovery. Emilio Goldenhersch agrees with those findings. He’s the co-founder and CEO of San Francisco, Cali.-based MindCo Health. He’s also an addiction expert, TEDx speaker and a former smoker whose nicotine addiction is in remission.
“If you are a smoker in an addiction treatment program, or you have recently completed one, you should be aware that smoking can cost you your hard-won long-term recovery,” Goldenhersch said. “The same mechanisms underlying smoking (triggers, cravings, automatic-pilot) are present in all other addictive behaviors. Therefore, in order to mitigate the risk of relapse, you should consider quitting smoking as well.”
This compares seamlessly with NIDA’s interpretation of the Weinberger study. In general, that research found smoking cigarettes to often go hand in hand with illicit drug use. As such, the constant correlation alone was enough to surmise that nicotine might be serving “as a drug cue and relapse trigger,” according to NIDA’s interpretation of that data. NIDA also reported – and the Weinberger study acknowledged – that research already pointed to nicotine exposure driving cravings for specifically stimulants and opiates.
Your Best Bet For Recovery
While it can be daunting to think about, your best bet is to start trying to quit smoking cigarettes once you’ve already started recovery from another substance. At Landmark Recovery, you’re allowed to smoke outside the facility while you’re enrolled in our addiction treatment program. However, the same therapeutic support you’re given for quitting your substance of choice will be available to you for nicotine as well. You’ll already be getting targeted therapy for your addiction.
You should also consider outpatient treatment, which already correlates with much greater long-term recovery success rates. You’ll continue to get support from a recovery community that can also help hold you accountable for quitting smoking. Should you enroll in Landmark Recovery’s Alumni Program, you’ll have people invested in your professional and extracurricular goals, too.
Call our addiction specialists today at 888.448.0302.
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