According to a report published in the July issue of Alcoholism: Clinical and Experimental Research cigarettes which are often used as a crutch during the first year of recovery actually stifles critical mental functions. The Science Daily summarizes the report and brings out a few choice tidbits about the relation between smoking, alcohol, and addiction.
I know my half-pack habit a day went to two packs* after I quit drinking, but I didn’t realize that this habit I thought kept me sane may have actually been hampering my recovery. (I had almost quit smoking by the time I hit rock bottom because I could not afford smokes AND alcohol, and you know what had to come first!)
“Alcoholics frequently smoke. Anywhere from 50 to 90 percent of individuals in North America who seek alcoholism treatment are also chronic smokers. New findings indicate that smoking may interfere with alcoholics’ neurocognitive recovery during their first six to nine months of abstinence from alcohol.”
One of the authors of the study, Timothy C. Durazzo, also gave a possible explanation for something I have heard all my life, “I only drink when I smoke”.
“Nicotine and alcohol may enhance each other’s rewarding properties; nicotine may decrease some of alcohol’s negative effects on cognition and motor incoordination; paired use of nicotine and alcohol may produce a strong association between the two substances such that the use of one leads to cravings for the other; and there may exist a genetic vulnerability for concurrent active cigarette smoking and alcohol dependence.”
What this study boils down to is that smoking doesn’t necessarily increase the chance of relapse, but it definitely hobbles mental efficiency and higher-level reasoning and problem-solving abilities which are detrimental to anyone who is at a point in life where they can use all the help they can get.
My opinion, which was recently appraised at $.03 slightly above the my-two-cents average, is not to worry about this study. If you haven’t started smoking yet, don’t let the old recovery pros in the meetings and groups lure you into it. If you are already a smoker, concentrate on quitting drinking first and smoking only after you have gained solid footing in your recovery.
*For the record, I have been smoke free since 2003!
{ 12 comments… read them below or add one }
I have done it both ways and failed in both ways. I agree with TDA in that it’s much easier to rationalize the relapse of smoking a cigarette in that you really are only hurting yourself (if you don’t inflict second hand smoke on anyone) and no one dropped dead or ruined there lives by smoking one cigarette. And that might put you one step closer to rationalizing relapse of another substance.
But I also agree with the doctor that quitting both will make you think clearer and feel better and perhaps give you better chance of kicking both.
When I tried this latter method I found that my nicotine addiction had longer lasting physiological cravings than even my alcohol addiction. I would (now this is only me speaking from my experience and it may be that the effects I describe were actually brought on by some latent alcohol withdrawal) get headaches several months (11 weeks) after I quit both that I thought were the result of desiring a cigarette (which I did – badly), but not alcohol (or so I thought); after succumbing to nicotine again the headaches did go away.
I do believe (again my own experience) that physiologically cigarettes are harder to quit than alcohol. But that alcohol is harder to quit mentally. That being said I think it takes an extremely strong person to quit both at the same time and someone not so strong may just say blank it and start using both again as addicts are apt to do – and maybe even throw in a new addiction for good measure.
One day at a time – one vice at a time – if you have that luxury.
I’m not sure this makes sense – but good discussion from the doctor and TDA.
Screedler
Hi there. I’m sorry–it was me who did the “smoking drinkers” post. I wrote it right before I had to go to an appointment and didn’t realize that I was actually posting it–I thought I would do that later. Any way, pleased to find this site–I’m at the point in my own recovery where I am looking for new avenues of information, and this looks very interesting. Thanks.
Unfortunately, many (including treatment providers) are still of the opinion that an individual who has both a drinking problem and smokes should address their alcohol dependence/abuse first. There is no empirical evidence that quitting smoking and drinking at the same time hinders sobriety from alcoholism; to the contrary, there are recent studies that suggest quitting smoking and drinking concurrently may assist with the maintenance of sobriety from alcohol. The fact is, over four times as many individuals die each year from smoking-related diseases (about 440,000) than from alcohol-related diseases. Considering what we know about the multiple adverse health effects of smoking and its potential negative affects of brain biological and cognitive recovery, trying to quit smoking and hazardous drinking at the same time may be advisable.
Timothy C. Durazzo
University of California San Francisco
both for the study and taking the time to post here at the The Discovering Alcoholic. This was the first time I had seen any scientific link between drinking and smoking even though I guess it is an accepted fact on the street.
Statistically smoking may directly claim (cut short) more lives than alcohol and drug abuse, but I would think that it would be statistically the opposite (see Collateral Damage) if you were able to accurately gauge how alcohol and drugs destroy lives. Not only of the user but of all those around them including family, friends, employers, strangers and even future generations. I mean when was the last time you same someone http://www.courant.com/news/local/hcu-vernoncrime-0626,0,7593064.story?coll=hc-headlines-local>beating his wife and kids for cigarette money?
I also can accept the fact that quitting smoking and drinking concurrently may assist in the maintenance of sobriety, but I believe this to be true only in a clinical sense. Any addiction is difficult to beat and the physiological complexity of the disease may take precedence in an initial recovery, but in my humble opinion long term recovery is the ultimate goal. The lack of any short term consequences or reprisals for sneaking a smoke make a relapse much easier to rationalize and cigarette addiction that much tougher to crack. And of course this can set precedent for other rationalizations and relapse. Any relapse or failure in recovery can have great repercussions including guilt, depression, and loss of self confidence which in turn are great motivators and triggers for the return to drugs and alcohol.
I agree that trying to abstain from both the smoking and drinking would be the ideal path, but I think in the long term it does more harm than good.
I appreciate your perspective on this matter and much of what you state has merit. However, I am compelled to share my experiences as a researcher and clinician with respect to cigarette smoking. You indicated alcohol/drugs can destroy lives -very true. However, so can chronic smoking. Recently, I found a very aggressive brain tumor on the MRI of one of our smoking alcoholic research participants who was sober for 1 year. The tumor was not present on his baseline scan the year before. He also has developed lung cancer (likely from smoking) and the brain tumor likely spread from his lungs. His chances of survival are very poor. Unfortunately, this very sad scenario is not a rare occurrence. You are very right in saying smoking is difficult to kick. However, there is promising on-going clinical research at the UC San Francisco and the San Francisco VA Medical Centers that is devoted to evaluating different behavioral and medication treatments to specifically assist individuals with alcohol/substance issues with smoking cessation. Each individual must evaluate if it is realistic for them to quit both at the same time, but ultimately continued smoking during recovery is not a benign behavior and significantly increases one’s risk for future health problems and declines in cognitive function. In my opinion, it is tragic to attain long-term sobriety only to develop significant health problems or have one’s life cut short because of smoking-related disease. My point here is there is no harm in attempting to quit smoking and drinking at the same time.
Respectfully,
T.C. Durazzo, PhD
University of California San Francisco
I have learned something from your work and I hope you will drop by in the future.
This stuff is so hard. Neither my husband nor I smoke cigarettes, but I’ve been struggling to keep my hands off his use of substances besides heroin. Since he’s been clean (about 10 weeks) from heroin, he’s had a few drinks a few times (drank until he was drunk once) and smoked pot a few times. While using heroin, he never drank or smoked pot, and he’s never been a big pot head or drinker. In fact, when I first met him, he was always the sober one–the designated driver, even, for all our drinking and carrousing college friends.
What I want is for him to be one of those tee-totalling, NA attending, “I’ve seen the light of sobriety and it is good” people. I want him to give it up, all of it, forever. But, unfortunately, it’s not about me. My boundary is no heroin or cocaine. I can’t live with heroin or cocaine in my life. I have decided that the rest of it is not my bucket of shit…until the shit starts splashin’ up on me…
So I don’t have a lot to say about cigarettes and addiction. I have wondered, though, when I go to my Nar-Anon meetings that are held in conjunction with NA meetings and I see all the NA folks standing outside chain smoking before and after their meetings, how they can justify getting rid of one addiction while keeping another that is (at least physically) also destructive. I think I agree with TDA, though, about the collateral damage effect of the primary addiction…those substances that can make you beat your wife or sell your mama’s ass are the ones that have to go.
The Junky’s Wife
I have found that quitting both smoking and my drug habit at once worked well for me. It just seems that if you are going to be changing so much about yourself…you might as well go for broke.
Not only does this apply to quitting addictions but I think it also goes with any other behaviors or routines that we are trying to change. When I had started at a new company (this was a while ago) I knew that I had to now change my morning routine. I figured, if I was going to have to change my commute and the time that I leave the house…why not try to fit the gym into my morning routine? By starting both of these new things on the same day it made the transition to both seem a lot easier.
When I had gone into rehab for my opiate addiction I had made the decision that I was quitting everything. The hospital that I was in had no smoking on the grounds (couldn’t have gone outside if I wanted to). I decided that I didn’t even want to take the nicotine patches that were offered (almost forced on me). I figured I was going to be feeling like sh#t anyway so why not get it all out of the way at once.
I am really glad that I made this decision. I understand the argument that cigarettes, being an addiction, is not as serious as drugs or alcohol. While I do agree with the theory that relapsing on cigarettes is not going to end your life, I think it puts you on a course of possibly ending your sobriety.
If you are truly wanting to be on the road to recovery and work towards staying sober then why allow yourself to actively abuse something you are addicted to? What kind of signal does this give to your brain, even subconsciously?
I am definitely NOT saying that because you smoke you are not truly sober. I’m saying that in the long run I think it would be easier for people to quit all substances that they are addicted to at once and work on total abstinence from chemicals that you are dependent on (except coffee because I like that too much!).
Erin at What Winners Do
While giving up both might be ideal for recovery, this old codependent has learned that you can’t control someone else’s recovery (even if you know what’s best for the addict, which we codependents totally do).
Regardless of whether we think the health damage from cigarettes or the collateral damage from alcohol is worse, each addict is going to do what s/he’s ready for when s/he’s ready for it.
I’m most familiar with sex addiction, and many sex addicts only begin recovery for their sexual addiction after they have spent months or years in AA or NA. They don’t see until they begin to get sober that their sexual acting out was unmanageable independent of the the drinking or drugging and wasn’t caused by it. I imagine the same could be true of smoking and drinking; someone who is an alcoholic and a smoker may remain in denial about one addiction while recovering from the other.
I am forty one and started daily drinking and smoking around the age of fifteen. I hardly smoked at all by the time I crashed and burned from twenty years of drinking, and spending about three months in hospitals pretty well stopped it altogether. However, once I was back in the real world and attending AA and all that good stuff, I started back on the smokes, to a far greater degree than ever before. It seemed like everyone was smoking and drinking that god awful coffee that seems to be recovery tradition, and I went along with it. Did it help? I’m not sure, but after about a year and a half, I gave up the cigarettes too. It wasn’t even difficult–I just used what I have learned about my own addiction patterns and put my mind to it, and these days I am so grateful that I don’t have to scrounge up the money for cigarettes or live with the stink the habit puts on everything. And I feel a lot better.
I think, and this is just a personal opinion, that everyone’s experience with addiction and cross addiction is different. For some people, smoking seems to help them quit something else that is for them far more immediately damaging. For others, giving up both at the same time works. However, I think most of it is about recovery tradition, and I know that a lot of the networking I did in early recovery was around the smoke breaks and coffee get togethers and not so much about what happened in the actual meetings. I know that when I go to a meeting now, I miss a lot of that because I don’t want to stand around in a cloud of cigarette smoke during break time or after the meeting. However, for me, quitting smoking was just another stepping stone to getting healthy, both physically and mentally, and I’ve had to make a little more effort to connect with fellow drinkers outside of meetings. As I have a sponsor who chain smokes, sometimes it can be difficult. But I do it, because that’s what I have to do for myself in my recovery, and just because she still smokes doesn’t mean she doesn’t know an awful lot about staying sober. It a personal journey, and no one can “work my program” for me, and vice versa. Do I want my AA friends to quit smoking? Absolutely, because it is such an unhealthy, stinky, and expensive habit. However, I know enough about recovery now that I have no judgment around those who still smoke like chimneys. It takes what it takes and we are all individuals.
is very similar to your own. My recovery program keeps me moving forward and looking for continuous improvement. Kicking cigarettes was just the natural progression (albeit a difficult one, very).
Thanks for your comments, I hope that you will log in next time so I will know who you are.
Take care,
TDA
no, no, no, don’t tell me to also stop smoking…. it makes sense what you wrote, but i feel i need to keep at least one vice, heee heee heee