Drug Addiction Smoking almost always occur together, rarely does someone who is drug addicted not smoke. Why do drug addicts almost always smoke cigarettes? There has been some research done in this area to try to figure out why most drug addicts smoke and how much harm it does to them. The results listed below are the summary of their findings:
Prevalence of Nicotine Dependence in Addiction
The American Psychiatric Association study found that “Nicotine dependence is the most prevalent substance abuse disorder among individuals with mental illness (including drug addiction). Cigarette smoking adversely affects the quantity and quality of life for patients with drug and alcohol addiction, is predictive of future suicidal behavior, and can reduce the effectiveness of a number of psychiatric medications. Treating smoking can be considered one of the most important activities all of us can perform.
Population-based studies suggest that individuals with drug and alcohol addiction smoke at more than twice the rate of the general population (61% versus 23%), with even higher rates among the seriously mentally ill. Because addicts are often heavy smokers, individuals with co-occurring mental illness or addictive disorders are now estimated to comprise 44% to 46% of the U.S. cigarette market. This equates to 175 billion cigarettes and $39 billion in annual sales according to the Federal Trade Commission.
Smoking is a gateway drug for teens
Smoking may serve as a gateway to other drugs of abuse for youth with substance use disorders and is particularly prevalent among these individuals. Studies have found that more than 80% of youth with substance use disorders report current tobacco use, most report daily smoking, and many if not most will become highly dependent, and long-term tobacco users.
Why is Cigarette Smoking So Prevalent Among Addicts?
Both neuro-biological and psycho-social factors have been identified as contributing to the elevated rates of cigarette smoking among drug and alcohol addicts, including the reinforcing mood-altering effects of nicotine, shared genetic factors, and reduced coping ability for quitting.
Cigarette smoking in mental health has a long history with negative consequences. Sigmund Freud, the father of psychoanalysis, was a heavy smoker—averaging 20 cigars a day. Despite recommendations from his physician, a diagnosis of oral cancer, undergoing 33 operations for cancer of the jaw and oral cavity, jaw replacement, pain, and suffering from “tobacco angina,” Freud continued to smoke up until his death, attributed to cancer, in 1939 at the age of 83.
In a chapter on the behavior of therapists during treatment sessions, a 1951 handbook for psychotherapy encouraged tobacco use in sessions “as a small pleasure that you should feel free to enjoy”. Amazingly, to this day, higher rates of cigarette smoking have been reported among psychiatry residents and practicing psychiatrists relative to other medical specialties.
In comparison with other health care providers, psychiatrists are less likely to treat cigarette smoking; this phenomenon may be related to their higher smoking rate. Prioritization of mental health treatment, lack of an appreciation of the health effects of cigarette smoking, and beliefs among clinicians that persons with addictions are not able or willing to quit have contributed to a culture in many treatment settings that accepts and “normalizes” cigarette smoking.
Psychiatry settings have a long history of providing cigarettes to patients, an effective contingency for rewarding treatment compliance. Mental health patient advocacy groups and the tobacco industry also successfully fought efforts by hospitals, and states to ban cigarette smoking in inpatient psychiatric facilities.
Drug Addiction Smoking: Cigarettes promoted for self-medication
The tobacco industry has marketed its product to persons with mental illness, provided tax-free cigarettes to psychiatric facilities, and funded research promoting a self-medication hypothesis for nicotine. Viewing tobacco as an increasingly “downscale social activity,” the tobacco industry marketed its “value” brands to “street people,” a substantial number of whom have addictions.
The tobacco industry also used service providers in homeless shelters, psychiatric facilities, and drug treatment programs to further its political goals. Tobacco’s place in alcohol and drug treatment is similarly long-standing and detrimental. Both of the co-founders of Alcoholics Anonymous (Bill Wilson and Dr. Bob Smith) smoked heavily and died from causes related to their cigarette use.
Drug Addiction Smoking: Nicotine addictions may not focused on in treatment
Historically, treatment of tobacco dependence is not included in most addictions treatment settings. A few years ago, in a survey of more than 200 addictions treatment programs, only 10% reported offering formal smoking-cessation programs. Tobacco use is also prevalent among addiction counselors, who themselves are often in recovery from alcohol and drugs.
Having experienced the “normalization of tobacco” within the addiction treatment and 12-step communities, counselors may continue to perpetuate its use by smoking with clients and discouraging quit attempts out of fears that sobriety may be compromised. In focus groups conducted with patients recruited from methadone clinics, about a third reported actually being advised by friends, treatment staff, and Alcoholics Anonymous/Narcotics Anonymous (AA/NA) sponsors to delay quitting.
Unlike alcohol and non-nicotine drugs, cigarette smoking has few immediate consequences and cessation has not been a priority. Yet, among individuals treated for alcohol dependence, tobacco-related diseases were responsible for half of all deaths, a proportion that is greater than alcohol-related causes. In a 24-year study of long-term drug abusers, documented the death rate among cigarette smokers to be four times that of nonsmokers.
The health consequences of tobacco and other drug use are synergistic and estimated to be 50% greater than the sum of each individually.
Although smoking seems benign as compared with alcohol and drug addiction, in the long run nicotine addiction can be just as deadly.