Substance Use Disorders

 Importance of Combining Smoking Cessation with Substance Use Disorder Treatment 

Why should tobacco cessation services be offered within substance use disorder treatment? 

The percentage of people receiving treatment for substance use disorder that smoke cigarettes is quite high, with reports ranging between 67 - 98%,¹ much higher than the 17.8 % of the general population in the U.S. who smoke.² Research predicts that people who smoke will lose at least 10 years of their life due to smoking.³ who smoke and receive treatment for substance use disorders are more likely to die from   Clientssmoking- related diseases than from complications of substance use.¹²   
 

Given this significant relationship between substance use disorders and tobacco use, the US Department of Health and Human Services recommends a combination of treatments to address nicotine use concurrently with other problem drug use.¹⁰ However, most substance use disorder treatment providers do not offer nicotine treatment. ⁵    

Would focusing on smoking cessation during the treatment of other substance use disorders possibly worsen the likelihood of people quitting substance use? 

In a review of several clinical studies, smoking interventions provided during the time of addiction treatment led to a 25% increase in ¹⁰ Thus, addressing an alcohol user’s nicotine consumption at the same time can be effective in maintaining treatment goals and preventing relapse.¹¹Offering smoking cessation services can improve treatment outcomes among clients in treatment for other substance use disorders.  For example, as nicotine and alcohol are often paired by users, the use of one can serve as a trigger for the other.likelihood of abstinence from both alcohol and illicit drugs.⁶  The benefits of reducing smoking during substance use disorder treatment may also help recovery efforts for the long term.  A recent study found that people with alcohol use disorders who quit smoking reduced their rate of relapsing on alcohol three years later.⁷  

But substance use disorder clients may not want to quit smoking, or attend smoking cessation groups even if offered, right? 

Like other people who smoke in the U.S., most people who smoke and receive treatment for substance use disorder are knowledgeable about the harmful health effects and are interested in quitting.10 Many studies support the willingness of smokers to receive treatment for cessation within their substance use disorder treatment setting.^8,9Studies also have found that client discharge rates did not increase after smoking cessation efforts were implemented.⁹ 

What are some things substance use disorder treatment sites should know if they are interested in starting smoking cessation services?  

As part of a wider push to address nicotine use within substance use disorder patients, Medicare now offers smoking cessation counseling benefits that include two tobacco cessation attempts per year for enrolled patients. 

Before implementation efforts are initiated, barriers should be addressed.  For example, addictions counselors who smoke themselves are less likely to discuss smoking cessation with their clients .¹³ Programs that have successfully adopted smoking cessation services for clients, often have parallel cessation services for their staff. Overall, smoking cessation efforts are more easily implemented when treatment providers feel supported and when staff recognize the importance of providing smoking cessation services.