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Research on Tobacco and Addiction
Bill W., principal author of Alcoholics Anonymous,
planned to write another book titled After Sobriety, What? Unfortunately,
that project was cut short by Bill's death from emphysema-the
legacy of a lifetime of heavy smoking.
Today there's a new answer to Bill's Question: After sobriety
based on freedom from alcohol/drugs comes the issue of tobacco
addiction.
Of course, quitting tobacco is not a requirement for quitting
alcohol and other drugs. People can achieve a satisfying sobriety
even if they continue smoking. At the same time, many alcoholics/addicts
do try to quit tobacco, and many of them succeed.
Today the single greatest cause of disease and premature death in America is tobacco use. Each year, diseases related to tobacco kill 430,000 Americans. Nearly ¼ of American adults are smokers. 3,000 children and adolescents become regular tobacco users every day.
The U.S. Public Health Service pegs the annual cost of tobacco-related death and disease at $100 billion. Hard drinkers and drug users are stereotyped as heavy smokers, and research supports that view. Studies indicate that:
" Between 80 and 95% of addicts smoke cigarettes, a rate that is more that three times that for the general American population.
" Nearly 70% of addicts are heavy smokers (smoking more than a pack a day).
" Heavier drinkers puff their cigarettes more and draw in more smoke with each puff.
Unfortunately, heavy smoking and heavy drug use create a life threatening synergy: Using both cigarettes and alcohol over the long term increases health risks more than using either of them alone.
When compared to people who neither smoke nor drink, smokers are 7 times more likely to develop mouth and throat cancer; drinkers are 6 times more likely; and those who smoke and drink are 38 times more likely.
Other research indicates that nicotine addiction is the number one killer for people in recovery from other chemical addictions. Moreover, research also indicates that people who continue to use nicotine while abstaining from alcohol or other drugs relapse twice as frequently as those who quit the nicotine early in recovery.
For all of these reasons, we see that successful recovery means having to address nicotine too. We ask all family members to abstain from nicotine use.
Options for Quitting increase
According to the federal government's latest
guidelines for health professionals, current treatments for tobacco
dependence offer the "greatest single opportunity to staunch
the loss of life, health, and happiness caused by this chronic
condition."
The bottom line is that smokers who want to quit have more options
than ever before. The guidelines list four kinds of nicotine
replacement therapies: Nicotine gum, the nicotine inhaler, nicotine
nasal spray, and the nicotine patch. These treatments aim to
reduce withdrawal symptoms, allowing people to consume nicotine
in highly controlled and steadily decreasing doses. In addition,
replacement therapy provides nicotine without the toxins found
in cigarette smoke.
These guidelines also recommend 3 non-nicotine medications to reduce withdrawal symptoms: the antidepressant bupropion (zyban), the most commonly prescribed non-nicotine medication to deal with tobacco dependence, and clonidine and nortriptlyline, 2 second-line medications that require more medical supervision. The guidelines endorse counseling for everyone trying to quit.
We have found that Zyban and counseling work best for young people, and that the patches are ineffective if not dangerous. Consult with your physician when considering any of these guidelines.