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ABSTRACT: Smoking rates among persons with a history of alcohol abuse are triple that of the general public. Strong evidence indicates that the risk of cancer and cardiovascular disease is higher in recovering alcoholics than in peers who smoke, but do not drink alcohol. Yet these persons often receive less than optimal tobacco counseling out of fear that attempts at smoking cessation will jeopardize their sobriety. Recent research, however, does not support this belief; rather, it suggests that smoking cessation may actually enhance alcohol abstinence. A model for more effective counseling of smokers in recovery is presented, including an algorithm for assessing stages of readiness to change, with activities tailored for each stage. Specific motivational counseling techniques may be useful in encouraging recovering alcoholics to progress to the point that they are ready to change their smoking behavior.
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