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Smoking Cessation in Recovering Alcoholics: Fiction Versus Fact
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Am Fam Physician. 2000 Mar 15;61(6):1889-1890.
“Smoking isn't a bigger problem for people in recovery than it is for anyone else. You're just trying to scare me.”
Fact: Almost 85 percent of people who are in alcohol recovery smoke, compared with 25 percent of the general public. Smokers in alcohol recovery may be more addicted to nicotine than smokers who don't have a history of alcohol abuse. People in alcohol recovery often smoke more than smokers in the general public.
“Quitting smoking will threaten my sobriety.”
Fact: Until recently, we thought that quitting smoking made it harder to stay sober. We now know that smokers who are in recovery from alcohol abuse can stop smoking without starting to drink again. Because smoking and drinking usually go together, smoking can lead to a stronger craving for alcohol. So quitting smoking during treatment for alcoholism, or right after treatment, can actually increase your chances of staying sober. People who have been off smoking for a long time say that they feel more in control of their lives, less anxious and less depressed than they felt when they smoked.
“Alcohol addiction was the biggest threat to my life and my health, and I've quit drinking. Smoking won't hurt me that much.”
Fact: Make no mistake about this: smoking is an addiction, and it's as likely to kill you as any other addiction, maybe more so. Recovering alcoholics who smoke are more likely to get heart disease, lung disease and cancers of the head, mouth and throat. They are also likely to die earlier than people in the general public.
“People who are just starting alcohol recovery shouldn't try to quit smoking. My counselors told me to take one thing at a time.”
Fact: It's true, only you can decide when to quit smoking. Just remember, continuing to smoke when you're sober can increase your craving for alcohol if you used to smoke and drink together. Addiction experts strongly encourage recovering alcoholics who smoke to treat their smoking like any other any addiction—and get help to quit.
“Most people in recovery don't want to quit smoking.”
Fact: Research has shown that more than half of the smokers in chemical dependency programs would like to quit smoking. Almost two thirds of them have already tried to quit.
“I'm too addicted to quit smoking. I tried to quit before and failed because the withdrawal symptoms were just too bad.”
Fact: You may be more addicted to nicotine than other smokers, but there are ways to help you quit. Few people succeed the first time they try to quit smoking. Part of the problem may be that you tried to stop smoking on your own. If you couldn't quit drinking without the help of others, why expect to quit smoking that way? Lots of people and techniques can help you be successful: your doctor, nicotine replacement therapy, Nicotine Anonymous, friends and family members, the American Cancer Society, the American Lung Association, stop-smoking support groups, etc. All you have to do is ask for help.
When you stop smoking, withdrawal symptoms like irritability, nervousness, difficulty concentrating and constipation usually last no more than three to four weeks. Behavior therapy, along with nicotine replacement therapy, can help you with the withdrawal symptoms.
“I'll fail—I know I will. Quitting smoking will be harder for me than quitting drinking was. I just can't quit.”
Fact: There's a good chance that you felt this way at times about recovering from alcohol abuse. Feeling powerless and admitting you need help is the first step to kicking your smoking addiction. You need to approach quitting smoking the same way you approached quitting drinking—one step at a time. What gave you the strength and courage to give up drinking? The same tools can help you quit smoking if you just use them—treatment, therapy, group support, spirituality, friends and family, etc.
“I could never quit. Most of my family members and friends smoke.”
Fact: Being around smokers can make quitting harder. But giving up any addiction is hard. Asking family members and friends not to smoke around you gives them the opportunity to be supportive. At first it may help to stay away from other smokers. It also helps to practice what you'll do when you feel like smoking.
“I have too much stress in my life to quit right now.”
Fact: Your body is addicted to nicotine, so it feels better with the drug than without it. Maybe another time would be better. But remember that you, like all other people, will always be under some kind of stress. Waiting to be stress-free before trying to quit smoking may just be an excuse for not facing your nicotine addiction.
“I can't quit smoking because I'll gain weight, and that's bad for my health, too.”
Fact: Not everyone who quits smoking gains weight. Some people actually lose weight. If they do gain weight, most people gain only 5 to 10 pounds, which is much less of a health risk than smoking. Exercise and eating low-fat foods can help you keep from gaining too much weight.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2000 by the American Academy of Family Physicians.
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