By Laura Morrison-Roets, EdD, PhD, CTRS/L, LADC, CRAADC/Supv., CM III
The hazards of tobacco use in all forms has been widely discussed for years. However, an issue seldom addressed in the media, is that of tobacco use and cessation for individuals while in substance use treatment.
The Substance Abuse and Mental Health Services Administration (SAMHSA) states that combining smoking cessation and substance use disorder treatment increases consumer recovery success in the following ways:
- Quitting smoking increases the odds of long-term recovery, whereas continued smoking following treatment increases the likelihood of relapse to substance use.
- Tobacco cessation can have mental health benefits.
- Quitting smoking at any age has physical health benefits that begin almost immediately and continue for years.
- Quitting smoking can increase clients’ sense of mastery, helping them focus on a positive lifestyle.
For anyone who ceases to use tobacco, there are many short-and long-term benefits shared by the US Department of Health & Human Services:
Within 72 hours:
- Blood pressure and pulse rate return to normal.
- Carbon monoxide is eliminated from the body and the lungs start to clear out mucus and other smoking debris.
- There is no nicotine left in the body. The ability to taste and smell is greatly improved.
- Breathing becomes easier. Bronchial tubes begin to relax and energy levels increase.
From 2-12 weeks:
- Circulation improves.
- Coughing, wheezing, and breathing problems improve as lung function increases by up to 10%.
At 1 year, risk of a heart attack falls to about half that of a smoker.
At 10 years, risk of lung cancer falls to half that of a smoker.
At 15 years, risk of heart attack falls to the same level as someone who has never smoked.
There are many areas of concern and consideration for an individual who is both in substance use treatment and using tobacco. Once an individual has made the decision to quit tobacco use, he/she will be withdrawing and/or recovering from at least two (2) substances.
Next, the withdrawal from nicotine is considered by many to be as difficult, if not more difficult, than from heroin. The New York Times Magazine published an article, entitled “Nicotine: Harder to Kick than…Heroin,” in which, the following statement was made: ”Heroin addicts say it is easier to give up dope than it is to give up smoking,” says Dr. Sharon Hall, a psychology professor whose research at the University of California’s San Francisco medical school centers on methods of curtailing drug abuse”. Additionally, tobacco is a legal drug and extremely easy to obtain. Another obstacle is the temptation for the individual to use will be around constantly, because so many people use tobacco.
Relevant to substance use treatment programs, some facilities mandate a zero-tolerance policy for consumers, though staff may not address the recovery from tobacco use specifically; some have specific treatment protocol; and still others allow tobacco as a means of anxiety reduction for consumers, while dealing with other substance use recovery issues.
For the programs with specific protocols for smoking cessation, many of the same therapeutic techniques that are used for recovery from other substances are used. The programs may also utilize pharmacotherapy to assist in the cessation recovery process. Some of those include, but are not limited to, bupropion, Chantix, and nicotine replacement therapies such as gum, lozenges, inhalers, patches, and nasal spray.
First and foremost, is that for recovery to work, an individual has to sincerely want to quit. Treatment will typically then focus on education about tobacco use and the physiological and psychological effects in both the short-and long-term; counseling which teaches decision-making, coping, and healthy living skills; support for change; and teaching the individual how to change his/her environment in order to increase chances for recovery.
There are various programs available which teach smoking cessation programs for individuals, as well as instructors. For more information, two of those are: