By Danielle Owen, IIIC Director of Wellness and Education

For many people who I have worked with on their alcohol or drug problems, quitting smoking was usually the last thing they wanted to let go of. “It’s all I have left” they would say. For others in recovery, quitting the smokes was usually only considered when the person was a solid two or three years into recovery. They would then feel ready to try. Recent research however has prompted me to rethink how I work with people around this issue.

The National Institute on Drug Abuse (NIDA) reports that people who abuse drugs and alcohol are also likely to be cigarette smokers. This is no surprise to anyone in recovery! Just see how many chat with a smoke and a coffee outside a fellowship meeting, like AA or NA. However, as counselors, we generally focus on supporting a client who wants to quit their more “serious” drug(s), usually alcohol, cocaine or heroin. Smoking cigarettes is often seen as an addiction that can be addressed later.

Smoking cigarettes causes the feel-good, chemical dopamine to flood our brain giving us intense feelings of pleasure. This is very similar to what happens when we use drugs or alcohol. When someone stops using drugs and alcohol after using them in a harmful way, their brain misses the high levels of dopamine that these drugs produced. Adding smoking withdrawals to this mix seems like adding fuel to a fire!

However NIDA researchers found that craving for nicotine appears to increase craving for illicit drugs among drug abusers who smoke. In another study, scientists found that patients in drug treatment programs may be less likely to successfully stay off drugs if they are cigarette smokers. One of these researchers, a Dr. Heishman, believes these findings suggest that treatment for heroin, cocaine, or alcohol addiction might be more effective if it also included concurrent treatment of tobacco addiction at the same time.

So, in recovery, our brain has to remember how to produce its own Dopamine levels again, the way it did before we ever began to use alcohol, nicotine or other drugs. If we continue to smoke cigarettes, we undermine that progress to full recovery. Perhaps the extra recovery tool we need to consider is actually to let go of everything that makes these false, unnaturally high levels of dopamine. It might seem impossible but if continuing to smoke increases your chance of relapsing with alcohol, cocaine or heroin – bringing you back to all the pain your addiction brought before – maybe it’s worth the short-term pain for long-term recovery.

Nicotine patches and other products can help with cravings, and talking with others in a support group can help us learn new ways to cope without cigarettes. If you are ready, the IIIC is presently running a series of six-week smoking cessation support groups and will do so again in 2012, thanks to BPHC. They’re free and open to all who want to stop smoking. Interested? Call Danielle 617-542-7654 ext 14 for more information or to register. Also see www.nida.nih.gov.