Abstract
Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.
Highlights
Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses
Hser and colleagues [11] found that cigarette smoking contributes to mortality above and beyond deaths due to opiate use; in their 24-year follow-up of drug users that were admitted to drug treatment in 1964, the death rates of smokers were four times that of nonsmokers
Few data are available on the health effects of quitting smoking specific to drug users in recovery, but drug treatment patients who quit smoking have been shown to improve their quality of life [9]
Summary
Conceptual model and recommendations for treating tobacco in substance abuse treatment A working model (Figure 1) depicts the program attributes and specific interventions that current research suggests will contribute to high-quality tobacco treatment in drug treatment facilities. Government guidelines stress the importance of office systems for ensuring full and routine implementation of tobacco treatment Examples of such office supports include written policies and protocols providing rationales and methods for intervention, office forms documenting smoking status and treatment progress, electronic or paper record prompts for intervention and follow-up, routine distribution of selfhelp materials to smokers, protocols for referring smokers to tobacco treatment specialists outside the facility, procedures for prescribing/obtaining pharmacotherapy for smokers, and periodic record reviews to track facility performance on tobacco treatment among patients [72]. 6% of U.S methadone facilities offer acupuncture for smoking cessation, even though it has not been shown to be effective for helping people quit smoking [75, 80] Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with new interventions, proven to be effective for those in drug treatment, as they emerge [34]. The New Jersey initiative suggests that a combination of policy change, free staff training on evidence-based treatment, and governmental provision of pharmacotherapy together can promote widespread adoption of high-quality care [76]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
