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Drug Alcohol Depend. 2019 Feb 1;195:6-12. doi: 10.1016/j.drugalcdep.2018.11.017. Epub 2018 Dec 8.

Smoking cessation in the context of recovery from drug and alcohol problems: Prevalence, predictors, and cohort effects in a national U.S. sample.

Author information

1
Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA, 02114, USA. Electronic address: jkelly11@mgh.harvard.edu.
2
Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA.
3
Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA, 02114, USA.

Abstract

BACKGROUND:

Tobacco and alcohol and other drug (AOD) use remain prominent risk factors for morbidity, mortality, and health care utilization. Moreover, these often cluster together within persons, exponentiating health risks. Little is known regarding if and when people resolving AOD problems stop smoking, who stops, and whether recent general population trends toward smoking cessation are evident also among persons more recently entering recovery.

DESIGN AND PARTICIPANTS:

National cross-sectional sample resolving AOD problems (final sample n = 2002).

ANALYSES:

Weighted smoking/cessation prevalence; logistic regressions; Hazard-models estimated time to smoking cessation overall, and for different cohorts entering recovery during one of three decades: a) 2006-2015; b) 1996-2005; c) 1986-1995.

RESULTS:

Approximately 30% of U.S. adults in AOD recovery with a smoking history stopped smoking before entering recovery, 7% quit smoking and AOD use concurrently, 26% stopped after entering recovery; 37% still smoked. Among those quitting after entering recovery, the prevalence of smoking cessation 5- and 10-years later was 27.2% and 55.1% respectively for the 2006-2015 cohort and 14.9% and 34.5% in the 1986-1995 cohort; time to smoking cessation also was 60% shorter (5yrs vs. 8yrs). Time to smoking cessation was associated with education and income, but not 12-step participation or AOD treatment.

CONCLUSIONS:

Smoking rates among those in AOD recovery are more than double that of the general population but those entering recovery in recent years are stopping and stopping sooner. It is plausible that public health-oriented tobacco policy measures and easier access to smoking cessation aids may be contributing to this salutary trend.

KEYWORDS:

Addiction; Cessation; Cigarette smoking; Epidemiology; National; Recovery; Remission; Substance use disorder

PMID:
30557814
PMCID:
PMC6359967
[Available on 2020-02-01]
DOI:
10.1016/j.drugalcdep.2018.11.017

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