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Smoking Cessation Treatment at Substance Abuse Rehabilitation Programs
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Code: nwl990-DLD1.pdf
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Cigarette smoking is common among persons with drug and alcohol use disorders, with prevalence rates of 80-90% among patients in substance use disorder treatment programs. Such concurrent smoking may produce adverse behavioral and medical problems, and is associated with greater levels of substance use disorder.
Behavioral studies indicate that the act of cigarette smoking serves as a cue for drug and alcohol craving, and the active ingredient of cigarettes, nicotine, serves as a primer for drug and alcohol abuse (Sees and Clarke, 1993; Reid et al., 1998). More critically, longitudinal studies have found tobacco use to be the number one cause of preventable death in the United States, and also the single highest contributor to mortality in patients treated for alcoholism (Hurt et al., 1996).
Nicotine is a highly addictive substance that meets all of the criteria for drug dependence, and cigarette smoking is an especially effective method for the delivery of nicotine, producing peak brain levels within 15-20 seconds. This rapid drug delivery is one of a number of common properties that cigarette smoking shares with hazardous drug and alcohol use, such as the ability to activate the dopamine system in the reward circuitry of the brain. Besides its addictive properties, cigarette smoking is legal and socially acceptable in many settings, giving it greater availability than other drugs of abuse. With these factors in mind, it is not surprising that cigarette smoking is one of the most difficult addictions to beat, with quit and relapse rates no better than for alcohol or heroin (USDHHS, 1988).
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