How many recovering people smoke cigarettes? In Scotland, just under a fifth of the population smoke, but in treatment populations the rate is between 60-90%. Travellers looking for mutual aid meetings will often be guided by the group of smokers outside the church hall. Some of those people in long term recovery are dying of addiction.
There’s a bit of an elephant-in-the-room-thing going on here. There’s not a lot of acknowledgement of the cruellest of ironies: that people in recovery from alcohol and other drug dependence will still die of addiction-related disease. The fact is that about one in two of them will develop fatal pathology like cancer or heart disease because of smoking. Others will be impaired by chronic, smoking-related conditions.
There’s a nice little paper on this at NIAAA where some of the fallacies around this are busted. Here’s what they say:
“Myths surrounding concurrent treatment for smoking and alcoholism also include the ideas that smoking is a benign problem relative to alcoholism, that patients with comorbid alcoholism have either no interest or no ability to quit smoking, and that patients will relapse to alcohol if they quit smoking.”
Turns out none of that is true. What’s astonishing is that about 8 out of ten smokers will tell you they would like to stop. I wonder if the acceptance of smoking in the membership of mutual aid meetings is a barrier to quitting, a sort of normalisation of an unhealthy behaviour. We all do it, so it must be okay. It’s not okay, because some are dying of addiction to cigarettes and the failure of recovering people to address this is surely an oddly persistent and peculiar example of denial.
Overcoming denial, as everyone who has made the transition to recovery knows, is hard work. Smokers in recovery from alcohol and other drugs may want some help with the process. American Family Physician published a great article in 1998 which laid out the myths and the facts about smoking for recovering people. It is a brilliant tool and I recommend it to you.
Maybe switching to e-cigarettes will help, but as Jason Schwarz at Addiction and Recovery News says: not so fast! E-cigarettes are not without risks too, though these are more subtle. We’re not sure yet what the balance of risks is.
Here’s a powerful incentive though to those going through treatment. Prochaska and researcher colleagues found that those who quit smoking in treatment had a 25% reduced risk of relapse to alcohol and other drugs. Now that’s worth sticking in your pipe…
[A version of this blog was published in May 2014]