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Smoking Might Undermine Alcohol Abuse Treatment

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By Cheryl Steinberg

Smoking and sobriety seem to go hand-in-hand just like coffee and meetings. Just check out any meeting clubhouse or harken back to your days in rehab, where the highlight of everyone’s day was the ability to take smoke breaks between groups.

A new study, however, shows that smoking might hinder the success of alcohol abuse treatment, putting people who are addicted to both tobacco and alcohol in Catch-22 situation.

Smoking Might Undermine Alcohol Abuse Treatment

According to findings by the University at Buffalo Research Institute on Addictions (RIA), clients in alcohol treatment programs who smoke have shorter stays in their program when compared to non-smokers and, furthermore, may demonstrate poorer treatment outcomes than their non-smokers counterparts.

Deputy Director and senior research scientist at RIA Kimberly Walitzer, PhD, led the study, which looked at more than 21,000 adults seeking treatment from 253 community outpatient substance abuse clinics across the state of New York.

“The data suggest that smoking is associated with difficulties in alcohol treatment,” she says. “Tobacco smokers had shorter treatment durations and were less likely to have achieved their alcohol-related goals at discharge relative to their nonsmoking counterparts.”

According to the Centers for Disease Control, regular smokers make up less than 20% of people in the U.S. However, among people with alcohol use disorders, there is a much higher percentage of people who smoke.

In addition, both smoking and alcohol abuse are associated with unemployment, lack of high school diploma or GED, criminal justice involvement, mental illness and/or other substance abuse.

These associations are even stronger in women. In the general population, less than 15% of women are smokers, however, Walitzer’s data show that 67% of those seeking alcohol treatment were smokers, compared to 61% of male smokers seeing treatment. Furthermore, the results of the study show that women smokers have even more difficult circumstances to surmount as well as even poorer outcomes of their alcohol treatment when compared to men who smoke.

A possible solution is to treat both addictions simultaneously. This seems counter-intuitive to those seeking treatment for substance abuse and addiction, as well as those in the treatment field, from my experience, at least. Many tout the widely common idea “one addiction at a time” when it comes to overcoming addictions. They believe that there is a sort of hierarchy of priority when it comes to treating addiction, one that says to tackle the “harder” substances, like heroin, cocaine, and alcohol, first.

But, Walitzer says different: “Previous research indicates that if people can quit smoking when entering alcohol treatment, they may have better alcohol outcomes. However, simultaneous cessation is a task that is very challenging to accomplish.”

The study appears in the journal Substance Use and Misuse, and its co-authors are RIA’s Ronda L. Dearing, PhD, senior research scientist; Christopher Barrick, PhD, senior research scientist; and Kathleen Shyhalla, PhD, data analyst. It was funded by the National Institute on Alcohol Abuse and Alcoholism.

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