Can you be in recovery and still smoke?
Although there’s a fair bit of debate about what recovery actually is, there’s also some overlap between definitions. Many mention abstinence, wellbeing and citizenship. The first and the last of these in relation to smoking gave Prof. Thomas McLellan pause for thought when speaking a few years ago at a conference in New Zealand. Now I have my own concerns about the ‘blind spot’ in recovery communities when it comes to smoking. I’ve written about it in the most-viewed-ever blog on Recovery Review Why many in recovery are dying of addiction, and then again more recently in Smoking in recovery – the Blue Whale in the room.
I feel a degree of passion about the subject and am concerned about the one out of every two smokers in recovery who will die of a smoking-related illness. (And even as I type this I realise that smokers reading it will think ‘it’ll not be me.’) As I say, I feel passionate, but wouldn’t quite go as far as Prof. McLellan who poses a controversial point of view, no doubt to stimulate debate. I should say I have a lot of time for him and his research, but also because of his experience. He starts out with a solid premise:
“The consensus definition now used for recovery in the US, Britain and France is ‘a voluntary lifestyle characterized by sobriety, good personal health and citizenship’.
“By this definition, sobriety alone is not enough to qualify. The citizenship aspect also means acting in a responsible manner towards those around you. It is widely agreed those who simply stop drinking or using but do not change their attitudes and behaviors are not likely to remain abstinent for long.”
And there’s where the smoking thing comes in. Smoking represents unchanged addictive behavior. Can someone really be in recovery and still smoke?
“Logically we’d have to say no. Why would a definition of recovery emphasizing abstinence from drugs of abuse and good personal health allow individuals to use nicotine, the most abused drug in the world?”
I guess my mind instantly goes to caffeine, but then we don’t have overwhelming evidence of a link between premature mortality and caffeine. What is interesting for me is the silence on the subject in recovering communities and for silence you need denial, fear or collusion. Here’s what McLellan says:
“While work will definitely take place in the future to reduce or eliminate smoking among individuals in recovery, as of now even those who remain addicted to smoking and nicotine continue to have a place in these groups due to general consensus.”
And it’s the consensus that’s keeping people locked in to harm. So it needs to be challenged. After all there is evidence that stopping smoking in early recovery reduces relapse rates to a client’s drug of choice: