Can you be in recovery and still smoke?

Posted · 7 Comments

Wasted Man

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:


    7 Responses to "Can you be in recovery and still smoke?"
    1. Innocent Abroad says:

      I was detoxed from alcohol towards the end of 1997 but continued to smoke until early 2009 (when a chest pain alerted me to the need to do so).

      Certainly the recovery “industry” didn’t expect people to give up smoking in those days (there was even a smoking room in the hospital IIRC) and I am far from sure that recovery is the same as prolonged abstinence. The latter I think is a necessary but insufficient condition.

      This raises the question as to the extent to which addiction is a social, as well as a medical phenomenon. AA would deny that it has a social element, but perhaps AA is out of date!

    2. djmac says:

      I’m not sure what AA’s position is on the social determinants of alcoholism, but given that social networking is at the heart of mutual aid I doubt if too many members would deny a social element to recovery. So not only is AA not out of date, but the research has taken seventy years to catch up, so they were actually also ahead of their time!

    3. Chris says:

      I stopped drinking in 1997 as well but continued to smoke for over a decade. I can appreciate all of the issues raised above but I’m reasonably convinced that I would not made it out of early recovery without cigarettes. I can also endorse the consensus definition of recovery. The aspect I would clarify, for myself at least, is good mental health. The primary aspect of my mental health I concern myself with is self-awareness and the notion of being my “true self.” With that in mind I’m certain that I was in recovery despite my smoking. Of course, now I’m somewhat appalled that I ever smoked in the first place.

      Thanks for the post.

      • djmac says:

        I don’t agree with the notion that if you smoke you can’t be in recovery. In fact I’m not sure any rigid definition of recovery will ever be generally acceptable. I guess my worry is that there’s not much conversation in recovery communities about the irony of being in recovery, but still having a 50% chance of dying of addiction.

        Congratulations on stopping smoking!

    4. Grateful Co-Dependent says:

      I, too, appreciate this discussion. I was furious when I sent my spouse off to treatment in Oct 1991 that while they didn’t allow caffeinated coffee at this treatment center, they allowed him to take up smoking again even though he arrived as a non-smoker, as we had quit together six years earlier. He quit smoking again a short time after his return home, however the treatment center’s response to my complaints was to say no one would go there if they were a smoke free campus!

      When he went to treatment again after relapse ten years later, I told him if he came back smoking I would divorce him. I discovered after he was home, that he was chewing nicorette gum as he’d resumed smoking at this new treatment center. I didn’t divorce him and strive to not make threats anymore. He deals with his impulse to try to get away with something by striving for rigorous honesty.

      The irony is my husband is a cancer specialist and is today treating his sponsor who has over 20 years of sobriety in AA for terminal lung cancer. His sponsor never quit the cigarettes.

      Thank you for your topic. I am also grateful every day that I don’t smoke.

      • djmac says:

        It’s a cruel irony really to suffer from a smoking related disease while in recovery from another addiction. Bill Wilson, one of the founders of AA, also suffered from smoking-related lung disease.

    5. Barbara says:

      It’s pretty common, as far as I can tell, for people in recovery from drugs or alcohol to eventually address our addiction to nicotine (and to other things). But “One Addiction at a Time,” since they are all hard to deal with!

      I didn’t quit smoking completely till I had been sober for about 12 years – and it took me 10 years to do it, all together! But I was definitely “in recovery” all that time.

      I think that when a person comes to terms with a lot of bad habits/addictions, s/he really has to address the most serious ones first. That’s how it was for me, anyway…..

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