People enter recovery to free themselves from chemical dependency, but anyone who has been to a rehab community or 12-step meeting will immediately notice a large number of tobacco users. Studies have shown that as many as 50% of recovering alcoholics smoke cigarettes, yet few people seem to talk about it or be concerned by it. Many people even start smoking in recovery. Almost no one treats it with the same concern as the use of other drugs and alcohol, even though the negative health effects of nicotine addiction are well documented and often fatal in the long term.
Is Nicotine Addiction a Type of Substance Abuse?
Nicotine addiction is technically a form of substance abuse, as users become dependent on an unhealthy drug. However, there’s no doubt that it’s much more acceptable than other forms of substance abuse. In some social circles, smoking, vaping or chewing tobacco are even considered as normal as drinking a cup of coffee every morning. However, tobacco use is declining overall. As of 2018, the CDC estimates that only about 14% of adults in the United States smoke cigarettes.
Nicotine use does have many well-known negative side effects, but it doesn’t tend to have the same immediate impact on your life as many other types of substance abuse. Tobacco use typically doesn’t significantly affect your ability to hold down a job, spend time with your loved ones or maintain your mental health.
The Dangers of Nicotine Use
Although nicotine addiction is more socially accepted than other types of substance abuse, it brings its own set of dangers. Almost everyone is aware that it causes a significantly increased chance of lung cancer and other respiratory issues, such as chronic obstructive pulmonary disease, or COPD. However, tobacco use affects virtually every organ in the body. Tobacco users are also more prone to other forms of cancer, heart disease, strokes and even tuberculosis and rheumatoid arthritis.
Secondhand smoke from cigarettes is also harmful to those around you. It increases their chance of cancer and other diseases. The effects are particularly severe in children, who often suffer from slowed lung growth and develop asthma and other chronic illnesses due to exposure to smoke.
Nicotine addiction also often comes with a high social and financial toll. Whether you smoke cigarettes, use a vape or chew tobacco, there’s no doubt it’s expensive. Each individual purchase is small, but the steady amount adds up to thousands of dollars a year. Since it’s falling out of favor in the general population, smokers can also experience social isolation as others may not want to be around them. Taking smoke breaks at work can also lead to decreased productivity and may hurt your career in some workplaces.
Smoking and Addiction
So, with all that in mind, is it ‘living in addiction’ to be using cigarettes after rehab?
The answer is complicated. By the most technical definitions, people who are addicted to nicotine are still living in addiction. However, compared to other types of addiction, nicotine is usually significantly less harmful and more socially accepted. A smoker isn’t going to experience the same immediate effects as an alcoholic or heroin user would. People with a nicotine addiction are still able to take care of themselves and their responsibilities.
This is part of why many people see addiction as a hierarchy. There are certain addictions, such as an addiction to heroin or methamphetamine. On the other hand, there are more socially accepted addictions such as scratch-off cards or, to a degree, marijuana. Everyone who gets grumpy without their morning cup of coffee is technically addicted to caffeine, but few people see that as a problem. Nicotine addiction is seen by many as being more on the mild side of the spectrum.
While there is some truth to this — no one is suggesting you should go to rehab because you need coffee to start your day — this unspoken hierarchy can cause some problems for people who are addicted to more socially acceptable substances. Alcoholics often struggle to understand the difference between moderate drinking and substance abuse. People who are addicted to marijuana also are often hesitant to seek help, since marijuana addiction is often not seen as a real or serious problem despite its negative effects.
Examples of this spectrum of addiction make it difficult to declare what is an addiction, and in the case of the marijuana user, this perceived spectrum may discourage them from seeking help. For many, their addictive behavior is defined as ‘once I start, I cannot stop, I become self-destructive’. Since ‘overdosing’ on cigarettes is not a common issue or letting them ruin you financially is not often a concern, it creates an opportunity to discount them as a threat.
The Link Between Smoking and Rehab
So why do so many people in recovery smoke? For some, it’s simply a continuation of a habit they picked up while living in addiction. Some, however, may start smoking more while in rehab. Similarly, people who work in an environment where all of their coworkers smoke will likely begin smoking more. Smoking is so prevalent in some programs that there’s an old joke that you can find your nearest AA meeting by simply following the cloud of cigarette smoke. When most of your mentors and peers are smoking, it’s hard to abstain.
Addiction is about more than just chemical dependency, though. The underlying personality traits and mental health issues that make people prone to drug or alcohol abuse don’t just go away when you stop using the substance. Many people in recovery end up finding a substitute addiction to help them cope. For many, smoking fills that compulsive urge. Other common substitute addictions include overeating, exercising more than usual or throwing yourself obsessively into a hobby. While these can be soothing at first, substitute addictions can actually increase your chances of relapse over time.
Building a Healthy Life
Living with a nicotine addiction may seem freeing compared to other forms of addiction, and it is true that the short-term consequences are much milder. However, the long-term effects of tobacco use can be devastating. At FHE, we encourage people to create a truly healthy life. Our patients are encouraged to participate in our smoking cessation program to help you achieve those goals and build the life you want. If you’re struggling with any type of addiction, including nicotine addiction, call us at (833) 596-3502 to talk about your options. Our trained and compassionate counselors are available 24/7 to help you take the first steps into a new, healthier lifestyle.
