Summary: A large-scale U.S. analysis found that adults recovering from alcohol or other drug addictions were significantly more likely to maintain long-term remission if they also quit smoking. Using data from over 2,600 participants in the ongoing PATH Study, researchers discovered that those who went from being current to former smokers had a 42% greater chance of sustaining recovery from their non-tobacco addictions.
This relationship held true even after accounting for other factors that could influence outcomes. Experts say the results strongly suggest that addressing smoking should be a core part of addiction treatment rather than an afterthought.
Key Facts
- Increased Recovery Odds: Quitting smoking was linked to 42% higher odds of sustained recovery from alcohol or other drug addiction.
- Nationwide Data: Findings are based on a nationally representative sample from the PATH Study, making them widely applicable.
- Treatment Implications: Supports integrating smoking cessation into standard substance use disorder care.
Source: NIH
Adults who smoke cigarettes and are addicted to alcohol or other drugs were more likely to achieve sustained remission of their substance use disorder symptoms if they also quit smoking, according to scientists at the National Institutes of Health (NIH).
Based on their analysis of data from a large U.S. study of smoking and health, researchers believe the results clearly show the benefit of pairing smoking cessation with addiction recovery efforts.
“We now have strong evidence from a national sample that quitting cigarette smoking predicts improved recovery from other substance use disorders,” explained Nora Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA), which partly funds the study, known as the Population Assessment of Tobacco and Health (PATH) Study.
“It underscores the importance of addressing different addictions together, rather than in isolation.”
Scientists analyzed data from 2,652 people 18 and older who had a history of substance use disorder and who experienced a change in their recovery status over the next four years.
Participants in the PATH Study are asked annually about their smoking status and other substance use. In this analysis, a change in smoking status from “current” to “former” use of cigarettes was associated with 42% greater odds of the individual being in recovery from their non-tobacco substance use disorder.
People with addiction to alcohol or other substances have a higher likelihood of being addicted to nicotine as well. Previous research has suggested an association between smoking cessation and improved outcomes from other substance use disorders.
However, the authors note that most prior studies used data from treatment centers focusing on addiction to a single substance or from smoking cessation trials, and those that used nationally representative samples could not adequately test for an association with recovery.
Researchers believe the new finding is generalizable to the millions of adults with substance use disorder and accounts for numerous confounding factors, thus increasing confidence in the results.
“Although the health benefits of quitting smoking are well-known, smoking cessation has not been seen as a high priority in drug addiction treatment programs,” said Wilson Compton, M.D., deputy director of NIDA and senior author of the study.
“This finding bolsters support for including smoking cessation as part of addiction treatment.”
Although this was a longitudinal analysis that was strongly suggestive that quitting smoking plays a role in improved recovery outcomes from other substance use disorders, further research will be needed to definitively establish a causal connection.
Also needed is more research on the best ways to support smoking cessation among people in treatment or recovery for substance use disorders.
The PATH Study is an ongoing, nationally representative longitudinal cohort study of youth and adults who may or may not use tobacco products that is funded by NIH and the U.S. Food and Drug Administration.
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About this addiction research news
Author: NIH Office of Communications
Source: NIH
Contact: NIH Office of Communications – NIH
Image: The image is credited to Neuroscience News
Original Research: Closed access.
“Cigarette Smoking During Recovery from Substance Use Disorders” by Wilson Compton et al. JAMA Psychiatry
Abstract
Cigarette Smoking During Recovery from Substance Use Disorders
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). By self-reported race and ethnicity, 17.0% of participants (95% CI, 15.3%-18.9%) were Hispanic, 13.9% (95% CI, 12.2%-15.6%) were non-Hispanic Black, 63.1% (95% CI, 60.4%-65.7%) were non-Hispanic White, and 6.0% (95% CI, 4.9%-7.4%) were another non-Hispanic race (Asian, Native American/Alaska Native, Native Hawaiian/Other Pacific Islander, more than 1 race).
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.
