It has been reported for several decades that smoking is a gateway drug to other substance abuse disorders. So why is nicotine/smoking cessation not a regular part of the treatment of individuals suffering from substance use disorders?
"Key Takeaways
- Smoking cessation has not been seen as a high priority in drug addiction treatment programs.
- In a nationally representative sample, smokers who quit cigarettes had a 30% greater odds of being in recovery from a non-tobacco substance use disorder.
- The findings support the inclusion of smoking cessation as part of addiction treatment, researchers said.
..."
From the abstract:
"Importance
Cigarette smoking is more prevalent among those with than without other substance use disorders (SUDs). However, smoking cessation interventions are often absent from SUD treatment facilities.
Objectives
To inform smoking cessation and SUD care by assessing smoking status and SUD recovery over time to determine whether transitioning from current to former smoking is associated with sustained SUD recovery.
Design, Setting, and Participants
This cohort study was conducted among a nationally representative cohort of US adults with history of SUD from the PATH (Population Assessment of Tobacco and Health) Study. The PATH Study is an ongoing, nationally representative, longitudinal cohort study in the US. Analyses included adults (aged ≥18 years) in the wave 1 cohort (recruited in 2013/2014) assessed annually over 4 years until wave 4 (2016/2018). A second nationally representative cohort (from 2016/2018 to 2023) was also assessed in sensitivity analyses. Data analysis was completed from June 2024 to September 2024.
Exposure Cigarette smoking (never, former, and current use).
Main Outcomes and Measures
The primary outcome was SUD recovery, assessed via the Global Appraisal of Individual Needs–Short Screener SUD subscale, measured as high lifetime SUD symptoms (4-7 symptoms) and zero past-year symptoms (sustained remission) or high lifetime SUD symptoms with any past-year symptoms (current substance use or SUD). Fixed-effects logistic regression assessed within-person change in smoking and its association with SUD recovery, accounting for between-person confounders.
Results
Among 2652 adults from 2013/2014 to 2016/2018, 41.9% of participants (95% CI, 39.4%-44.4%) were female, and mean age was 39.4 years (95% CI, 38.7-40.3). ... Within-person change from current to former smoking was positively associated with SUD recovery: year-to-year change to former cigarette use was associated with a 30% increase in odds of recovery (odds ratio [OR], 1.30; 95% CI, 1.07-1.57), accounting for time-varying covariates and between-person differences. This association remained significant after lagging predictor by 1 year (OR, 1.43; 95% CI, 1.00-2.05) and in the second cohort assessed from 2016/2018 to 2022/2023 (OR, 1.37; 95% CI, 1.13-1.66).
Conclusions and Relevance
In this cohort study, within-person change from current to former smoking was associated with recovery from other SUDs. These results suggest that smoking cessation could be used as a tool to assist recovery processes and improve health among adults with an SUD."
Cigarette Smoking During Recovery From Substance Use Disorders (no public access)
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