Tobacco Use in Treatment: To Smoke or not to Smoke
There has been an ongoing debate when it comes to the topic of tobacco use in treatment. There are facts based on scientific studies and there are opinions based on personal experience, both of which account for something. We have all heard the statistics about tobacco use and the affect it has not only on the smoker’s health, but the health of those around the smoker. Even with all of this knowledge, many people still choose to use tobacco in everyday life, as well as in treatment, if they’re not prohibited.
In order to gain perspective from a non-scientific standpoint on the subject of tobacco use in treatment, I interviewed two Intake Specialists from Lakeview Health. Desiree and Kelly are both in recovery and have both spent time in addiction treatment facilities. Desiree was in a facility that allowed tobacco use, Kelly was not, and they both smoked prior to treatment.
“All I wanted to do in treatment was to smoke a cigarette. I thought about it constantly. No one prepared me for the weight I was going to gain while in rehab getting clean, and that can be a serious trigger for someone to go out and use again,” Kelly explained. “You gain weight when you quit using drugs and quitting tobacco use was no different. The stress of gaining weight only made me want to smoke a cigarette even more.”
When Kelly got out of treatment, she immediately started smoking cigarettes again, but didn’t relapse as far as hardcore drug use was concerned. She decided if she made it through treatment and got herself clean, she should be free of ALL toxins and then wanted to quit smoking. Her sponsor at the time advised her to wait a year, explaining that the first year of sobriety is the hardest and she should take it one step at a time. After Kelly got through that first year, she enlisted the help of a doctor who implored her to get a gym membership, start working out, and told her to stick with it for a while and he would help her quit smoking. Kelly did just that. She got herself physically and mentally ready to take the next step and with the help of her doctor and Chantix, she is now clean, sober, and tobacco free.
“One thing at a time,” Desiree told me. “Yes, tobacco is addictive and I was addicted, but it wasn’t ruining my life like my drug use was. I wasn’t lying to my family over cigarettes, I wasn’t missing work because of cigarettes; it was the least of my problems.”
We’ve all been told as long as we can remember that smoking is bad for you and can ultimately result in an early death. There’s no disputing this. It’s a fact and it’s supported by decades of research and scientific evidence. The following are some statistics provided by the CDC and AAFP:
- Pharmacologically, nicotine is as addictive as heroin or cocaine
- Higher relapse rates in smokers
- Cigarette smoking causes more than 480,000 deaths each year in the United States
- Smoking causes stroke and coronary heart disease—the leading causes of death in the United States
- Studies indicate that more than 80 to 95 percent of the chemically dependent are regular smokers
- Years of alcohol dependence inflict a great deal of stress on the body, which means that recovering alcoholics are at greater risk for tobacco-related illness
Although these are only a few facts and hardly scratch the surface as far as the effects of tobacco use, many treatment centers still allow patients to continue to smoke.
Lakeview Health is one of those facilities. While they do allow patients to bring cigarettes into treatment and provide designated smoking areas on campus, they also offer tobacco cessation classes for those patients who wish to stop smoking and encourage those who smoke to join the class. It is a voluntary six-week program which two of their therapists have been trained to facilitate through the Area Health Education Center Program at Florida State University (AHEC/FSU). Not all patients can complete the full program due to time restraints of their length of stay in treatment; however some patients do quit smoking prior to completion of the program.
Patients who volunteer to attend these classes are offered nicotine gum, lozenges, and patches to help them quit smoking. Throughout the course, they will learn about the effects of tobacco on their health, the health of those around them, relapse prevention, managing addiction, and developing a plan without tobacco use. The class also implements the Transtheoretical Model of Change which conceptualizes the process of intentional behavior change. This allows patients to better understand the stages they will go through while they’re modifying their behavior.
Some may think that it’s contradictory for an addiction treatment facility to allow patients to continue to engage in addictive behavior, however, it is important to conquer one thing at a time; similar to taking your recovery one day at a time. In a perfect world, conceivably, all addiction facilities would be tobacco free, but since we don’t live in a perfect world, the next best thing is to inspire people in treatment to be educated and learn the facts, until the transition can be made to a tobacco-free campus.
Lakeview Health ultimately wants patients returning to a functioning lifestyle free of drugs and alcohol, encouraging those who smoke to quit along the way. They believe becoming a tobacco-free facility is a process and they are working towards it one day at a time.
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