Brain nicotine addiction tobacco use disease Studies show that most smokers want to quit. Yet traditionally, drug and alcohol rehab centers haven’t made quitting tobacco a priority for those in recovery – and some even avoid addressing it.
Why? The old way of thinking was that if an individual has to give up drugs and alcohol, they should get a pass on smoking. Others believed that cigarettes help prevent relapse, by helping addicts relieve stress or cope with the challenges of sobriety.
None of that is true, said Dr. William Jacobs, Bluff Medical Director. “Quitting smoking does not interfere with treatment for drug and alcohol addiction, and it doesn’t threaten sobriety,” Jacobs said. “It’s one of the best things anyone can do for their health and wellbeing.”
Research shows that quitting smoking actually strengthens sobriety. A study published in 2014 by researchers from Washington University School of Medicine surveyed 5,000 smokers and found 50% had an alcohol use disorder either currently or at some point in their past, while 24% had a drug use disorder, either current or past.
When surveyed a second time three years later, 19% of smokers had quit. Those who quit were significantly less likely to continue to have an alcohol or drug use disorder and were less likely to have developed one, than those who kept smoking
Why Quitting Smoking Benefits Long-Term Sobriety
There are several reasons why quitting smoking benefits long-term sobriety, Dr. Jacobs said.
Nicotine, the addictive substance in tobacco, is a powerful chemical that works on the brain’s reward center by activating the neural pathways associated with feelings of pleasure and satisfaction. The brain interprets smoking as a positive experience – and is driven to repeat the behavior.
It’s why people keep puffing away even though the dangers of smoking are widely known. Smoking is the leading cause of preventable deaths in the United States, contributes to 90% of lung cancers, and also ups the risk for cancer of the bladder, throat, mouth, kidneys, cervix and pancreas.
Different drugs affect brain chemistry in different ways. Yet whether it’s tobacco, prescription opioids, heroin or another substance, addictions share many similarities. “The substance impacts the reward circuits of their brain, leading to a compulsion to smoke, consume or inject more of the substance, despite the negative consequences,” Dr. Jacobs said.
Eliminating substances – whether it’s tobacco, prescription pain killers or illegal drugs – that interfere with the functioning of the brain’s natural reward system promotes healing. “Abstinence from drugs, alcohol and tobacco is important in helping the brain return to a state of balance,” Dr. Jacobs said.
Quitting smoking also has powerful psychological benefits for addicts in recovery. Smoking can be a trigger for people to use alcohol and drugs, since those behaviors often occur together. “Continuing to smoke cigarettes makes relapse more of a risk,” Dr. Jacobs said.
Rehab is an Ideal Time to Quit Smoking
Patients at Bluff aren’t required to quit smoking, but it’s highly encouraged and support is provided. Patients are invited to participate in a smoking cessation group, facilitated by a therapist with training in smoking cessation. The group uses tools such as meditation and journaling to help build motivation for quitting, promote relaxation and manage anxiety and stress that may come along with giving up smoking.
“Nobody is interested in quitting when they get here,” said Program Manager Joy Clubb. “But we find that as people progress in their recovery, as they start to feel healthier and more at peace, the possibility of quitting smoking seems more achievable to them, and they’re much more open to trying,” Clubb said.
While in treatment at Bluff, patients take other steps to heal their body and mind from the damaging effects of addiction. Meals are nourishing and satisfying, but are also low in sugar, refined carbs and other ingredients that can contribute to mood swings and make cravings harder to resist.
Bluff also provides holistic and experiential therapies, such as yoga and meditation, art therapy and equine therapy, to help patients relieve stress, improve their physical fitness and restore their mental health and well-being. While designed for alcohol and drug treatment, these therapies also benefit those quitting tobacco as well.
If patients are interested, they can also use nicotine replacement therapies, such as the patch or gum, to help during those initial smoke-free days.
“The old school way of thinking was that giving up drugs, alcohol, sugar and tobacco was too much,” Dr. Jacobs said. “We now understand that addiction is a chronic brain disease. Eating right, exercising, getting sufficient sleep, and quitting smoking are all important in helping the brain heal. Abstinence from drugs and alcohol is an important step, of course. But we’ve found that adopting a healthy lifestyle is important in preventing relapse and managing the disease of addiction over the long-term. Quitting smoking is an important part of that.”
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