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Dr. MJ Bazos MD, Patient Handout

Smoking Cessation in Recovering Alcoholics

“Smoking isn’t a bigger problem for people in recovery than it is for anyone else.”

Fact: Almost 85% of people who are in recovery from alcohol are smokers, compared with 25% of the general public. Smokers in alcohol recovery may be more addicted to nicotine than other smokers. People in alcohol recovery often smoke more than other smokers.

People who have been in treatment for alcohol problems are more likely to die from tobacco-related diseases than from alcohol-related problems. These people have a higher risk of heart disease and cancer than recovering alcoholics who don’t smoke. Cancers of the head and neck are special problems for people with a history of heavy drinking and smoking.

“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.

“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 even 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.

“I’m too addicted to quit smoking. I tried to quit before and failed.”

Fact: You may very well be more addicted to nicotine than other smokers, but there are things that can help you quit. Very 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 resources can help you be successful: your doctor, friends and family members, nicotine replacement therapy, Nicotine Anonymous, 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 3 to 4 weeks. Behavior therapy, along with nicotine replacement therapy, can help you handle the withdrawal symptoms. Ask your doctor what treatment is right for you.

“I’ll fail -- I know I will. Quitting smoking will be harder for me than quitting drinking was.”

Fact: There’s a good chance that you felt this way about recovering from alcohol abuse at times. 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, such as treatment, therapy, group support, spirituality, friends and family, can help you quit smoking if you use them.

“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 and requires you to make your own choice about what’s best for you and your loved ones. 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 to quit smoking. But remember that you, like all other people, will always be under some kind of stress. Waiting to be stress-free before you try 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: Most people gain no more than 5 to 10 pounds, which is much less of a health risk than smoking. Exercising regularly and eating low-fat foods can help you keep from gaining too much weight.

Tips to Help You Quit Smoking

Before you quit smoking, try the following:

First, write down what you like about smoking and what you don’t like about quitting. Then reverse this process. Write down reasons to quit and reasons not to keep smoking.
Switch to a brand of cigarettes with a lower nicotine content while smoking the same number of cigarettes every day.
Cut out a few of your favorite cigarettes during the day.
For 3 to 5 days, use a notebook to keep track of when you smoke each cigarette. Also note what you’re doing and how you’re feeling when you reach for a cigarette. Look for patterns in your smoking.

To cope with craving and withdrawal when you quit, try the following:

Ask your doctor about using some form of nicotine replacement therapy, such as a nicotine patch, nicotine gum, nicotine inhaler or nicotine nasal spray.
Talk to your doctor about other drug therapies, such as bupropion (brand name: Zyban), that you might use just for a while to help reduce your cravings.
Consider starting an exercise program. Exercise often helps reduce withdrawal symptoms, and it gives you something to do when you get a craving.
Check with your doctor to find out about deep-breathing, relaxation and imaging techniques that can help you cope with stress and cravings.
Avoid doing the things that trigger your cravings for a cigarette. Look back in your notebook to find out these triggers.

To prevent relapse, try the following:

Plan ahead and practice how you’ll handle difficult situations, such as being around friends and family members who smoke, managing stressful situations and coping with negative feelings like anger, sadness and anxiety.
Look for smoke-free options, such as smoke-free Alcoholics Anonymous meetings and other support groups, like Nicotine Anonymous. Plan activities where smoking is unlikely or with family members and friends who don’t smoke. Sit in the nonsmoking sections of restaurants.
Remember that breaking down and having a cigarette doesn’t mean that you’re a failure or that you have totally relapsed to smoking. Instead, “climb back on the wagon” and try again.