Smoking Cessation During Substance Abuse Treatment

Cigarette smoking is pervasive among persons who are being treated for substance use disorders. The prevalence is 3to 4-fold higher than in the general population. Whereas approximately 20% of adults in the United States currently smoke, between 75% and 95% of persons in treatment programs for addictions are cigarette smokers.1-3 The consequences of dual addictions to cigarettes and other substances of abuse are dire. In a frequently cited study conducted over a decade ago, approximately 50% of patients who were followed after inpatient substance abuse treatment died of tobacco-related causes—a rate that exceeded deaths from alcohol-related causes (34%).3 These high tobacco-related mortality rates reflect not only the greater prevalence of smoking in this population but also the tendency for persons with substance abuse disorders to start smoking at a younger age, to be more dependent on nicotine, and to be particularly susceptible to certain types of cancer secondary to combined use of tobacco and alcohol (eg, cancers of the head and neck).4-6