Can People in Recovery Kick the Smoking Habit?

Smoking has devastating consequences for those addicted to it. Smoking is nothing more than a slick delivery system for nicotine into the blood stream. It is fast, efficient, and deadly. And smoking is a widely accepted habit for many drug treatment and rehabilitation programs in America. It is especially evident in many mental health programs which are treating people with serious mental illness. Smokers have an increased risk for cancer, lung disease, and cardiovascular disease. And on average, they die many years sooner than those who do not smoke.

In the drug treatment setting there is broad sentiment that smoking is a stimulus that calms and soothes people at a time where environmental and emotional stressors are apt to trigger a relapse. In other words, it is an anti-drug drug. Mentally ill patients and recovery populations commonly smoke. The connection appears to be tightly interwoven. Twenty years ago, the Joint Commission on the Accreditation of Healthcare Organizations (JACHO), now called the Joint Commission, advanced a nationwide ban on tobacco use in hospitals. Quite a battle ensued. Advocacy groups for the mentally ill argued that the banning of cigarettes would result in mass insurrection in treatment institutions. These protests caused JACHO to back down and exempt psychiatric hospitals from the rule. For those hospitals that voluntarily complied with the ban, there was little or no disturbance in patient behaviors.

In the drug treatment community, smoking is still widely accepted. And only recently have institutions begun to offer quit-smoking assistance to those who want it. The first obstacle in this initiative is to admit people in recovery actually do want to quit. There is little to doubt this population has the same desire to quit smoking as the general population. Typically, between 20-25% of smokers state that they intend to quit in the next 30 days. That number gets higher the further the time frame is pushed out. But efforts to assist patients with smoking cessation are weak. And smoking is an expensive habit. With a pack of cigarettes costing more than a gallon of gas, many people in recovery from substance abuse disorders are saddled with the additional financial burden of smoking.

Drug treatment programs should be encouraged to engage with patients and discuss smoking habits. They should provide resources and information needed to act on a tobacco dependency. Barriers to lifestyle changes are already down in the treatment setting, thus the opportunity to introduce smoking cessation initiatives are greatest at that time. But smokers have to be ready to quit, and building a foundation towards that willingness can take time, patience and resources. But with the tools and assistance available in the treatment setting, there are abundant reasons for making the effort to stop smoking. The fact that the recovering addict is more likely to die from smoking than he or she is to die from the addiction is a sobering fact. The time has come to provide effective smoking cessation resources to all who are seeking treatment for substance abuse disorders.

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