Ryan H. of West Babylon started smoking cigarettes at the age of 13. Alcohol soon followed, then marijuana and harder drugs. He went to his first substance abuse treatment facility at age 17.

Over the next nine years, he tried all kinds of ways to stop using drugs. He moved, joined the military, tried different religions. At age 26, when his pain got great enough, he managed to finally stop using and has been clean for the last three years. It was only once he was abstinent from drugs for a little while that he realized his cigarette smoking was as strong and debilitating an addiction as any other he battled.

“When I couldn’t get cigarettes because I couldn’t afford them, I’d be flipping couch cushions to try and find enough change to buy some or wondering what I could sell to get a few dollars,” he says. “When I was running low, I’d get that same feeling of panic as I did when I was using drugs.”

He finally quit smoking cold turkey after three weeks of what he calls painful withdrawal.

“I think if I would have quit smoking sooner, I would have woken up sooner to the fact that I was an addict,” he adds. “If you’ve been unable to stay clean and you’re still smoking, it could definitely be a factor.”

There is research that concurs. Experts say tobacco dependence is a chronic addictive disease. A 2017 study by researchers at Columbia University’s School of Public Health and the City University of New York found that people recovering from illicit drug abuse are twice as likely to be successful if they don’t smoke cigarettes. The study was supported
by the National Institutes of Health/National Institute on Drug Abuse and appears online in The Journal of Clinical Psychiatry.

The researchers studied data from 34,653 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions, but only those with a history of illicit substance use disorders according to The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria were included in the final sample.

Researchers have long explored the connection between tobacco dependence and illicit drug addiction, citing as one possible reason that nicotine, alcohol, and drugs of abuse all stimulate overlapping pathways in the brain that are involved in addictive behaviors.

DSM-V diagnoses Tobacco Use Disorder and states that tobacco products contain nicotine, an ingredient that can lead to addiction. As with other drugs, it produces dependence and withdrawal symptoms upon cessation.

Statistics show that between 75 percent and 98 percent of people with Substance Use Disorder also use tobacco, compared to only about 17 percent of U.S. adults in general.

Also last year, Eric MacLaren, who has a Ph.D. in Pharmacology and is a freelance medical writer in the field of drug abuse, published these findings on drugabuse.com:

• Patients in drug treatment who voluntarily quit have more total days abstinent from drugs and alcohol one year later than those who never stopped smoking.
• 74 percent of smokers who quit during treatment remained abstinent from alcohol and drugs after five years, compared to 50 percent who did not quit smoking.
• Patients who quit smoking in their first year of recovery are more likely to be abstinent from alcohol than smokers (53 percent vs. 40 percent) and drugs (82 percent vs. 72 percent) after nine years.

Bettina Bove, a Long Island-based licensed clinical social worker, says the studies sound logical.

“If an addicted person stops using all addicting chemicals then it would stop that rebound effect and increase the odds of stable abstinence,” she says. “Addiction is inherent in a person, not in the specific substance used … Any mood or mind-altering substance can be substituted and trigger the addictive nature and a relapse.”

Critics of the study say asking patients to quit cigarette smoking while they try to stop using drugs is “too difficult,” or will hurt patients’ chances of successfully getting sober. Research fails to bear that out. But Eddie F. of Massapequa says it’s true for him.

“If I had to give up cigarettes when I got clean, I’m not sure if I would be here now,” he says. “It took me eight more years of smoking. And I just celebrated 22 years clean.”

The New York State Quitline, a free service to help residents stop using tobacco, can be reached at 1-866-NY QUITS (697-8487) or at nysmokefree.com.

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