Breaking Two Cycles At Once: How Quitting Smoking Helps Fight Other Addictions

A large study in the United States showed that people with a history of drug addiction who quit smoking are about 30% more likely to maintain recovery compared to when they were still smoking. This suggests that including smoking cessation support in drug or alcohol use treatments can improve outcomes and overall patient health.

Smoking remains one of the leading preventable causes of death worldwide, responsible for more than eight million deaths annually, according to the World Health Organization. It is estimated that more than 1.3 billion people are smokers, with the highest prevalence in low- and middle-income countries.

Cigarettes contain thousands of chemicals, including highly addictive nicotine and toxic compounds such as tar, carbon monoxide, and heavy metals, which are directly linked to cardiovascular diseases, chronic respiratory diseases, and several types of cancer, especially lung cancer.

In addition to physical harm, smoking often coexists with other substance use disorders, such as alcohol and illicit drugs, as well as psychiatric conditions, such as depression and anxiety, forming a cycle of dependence that makes it difficult to quit all addictions.

This interrelationship between harmful habits makes smoking cessation not just an isolated health measure, but a strategic step that can positively influence an individual's overall recovery.

This study, conducted by researchers at the US National Institute on Drug Abuse, investigated the relationship between smoking cessation and recovery in people with substance use disorder, a condition characterized by problematic and persistent drug or alcohol use, causing significant harm to a person's life.

Previous research has shown that smoking is much more common among people with this type of disorder than among the general population. Despite this, addiction treatment programs often neglect interventions to help patients quit.

The researchers wanted to understand whether changing habits, specifically, transitioning from an active smoker to a former smoker, could positively influence the recovery of those who have had or still have substance use problems. To do this, they analyzed data from a large national study conducted in the United States, called the Population Assessment of Tobacco and Health Study.

They followed thousands of adults with a history of substance use disorder and assessed their behavior over several years. The individuals were interviewed repeatedly, and at each assessment, the scientists determined whether they currently smoked, had smoked in the past, or had never smoked. They also analyzed whether they still had symptoms of the disorder or were in recovery, which was defined as having no symptoms in the past year.

To measure the association, they used a statistical technique that allows comparisons between individuals at different points in their lives, thus reducing the influence of individual differences. In other words, if a person was smoking one year and quit the following year, the researchers assessed whether this coincided with an improvement in their substance use disorder.

They also considered factors such as age, gender, economic status, and other characteristics that could influence both smoking and recovery.

The results showed that quitting smoking increased the chances of recovery by about 30% compared to periods when the person was still smoking. This relationship held even when the scientists adjusted the calculations to account for confounding factors and even when they analyzed the effects of quitting smoking a year later.

The finding was also confirmed in a second analysis, with another sample of people followed in more recent years, showing that the effect is consistent.

The authors concluded that quitting smoking can be an important ally for those trying to recover from other drug or alcohol problems. This indicates that including smoking cessation programs within the treatment of substance use disorders would not only help reduce the risks of smoking but could also accelerate and sustain recovery overall.

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Cigarette Smoking During Recovery From Substance Use Disorders

Michael J. Parks, Carlos Blanco, MeLisa R. Creamer, John H. Kingsbury, Colm D. Everard, Daniela Marshall, Heather L. Kimmel, and Wilson M. Compton

JAMA Psychiatry. Published online August 13, 2025. 

doi:10.1001/jamapsychiatry.2025.1976

Abstract: 

Cigarette smoking is more prevalent among those with than without other substance use disorders (SUDs). However, smoking cessation interventions are often absent from SUD treatment facilities. To inform smoking cessation and SUD care by assessing smoking status and SUD recovery over time to determine whether transitioning from current to former smoking is associated with sustained SUD recovery. This cohort study was conducted among a nationally representative cohort of US adults with history of SUD from the PATH (Population Assessment of Tobacco and Health) Study. The PATH Study is an ongoing, nationally representative, longitudinal cohort study in the US. Analyses included adults (aged ≥18 years) in the wave 1 cohort (recruited in 2013/2014) assessed annually over 4 years until wave 4 (2016/2018). A second nationally representative cohort (from 2016/2018 to 2023) was also assessed in sensitivity analyses. Data analysis was completed from June 2024 to September 2024. Cigarette smoking (never, former, and current use). The primary outcome was SUD recovery, assessed via the Global Appraisal of Individual Needs–Short Screener SUD subscale, measured as high lifetime SUD symptoms (4-7 symptoms) and zero past-year symptoms (sustained remission) or high lifetime SUD symptoms with any past-year symptoms (current substance use or SUD). Fixed-effects logistic regression assessed within-person change in smoking and its association with SUD recovery, accounting for between-person confounders. Among 2652 adults from 2013/2014 to 2016/2018, 41.9% of participants (95% CI, 39.4%-44.4%) were female, and mean age was 39.4 years (95% CI, 38.7-40.3). By self-reported race and ethnicity, 17.0% of participants (95% CI, 15.3%-18.9%) were Hispanic, 13.9% (95% CI, 12.2%-15.6%) were non-Hispanic Black, 63.1% (95% CI, 60.4%-65.7%) were non-Hispanic White, and 6.0% (95% CI, 4.9%-7.4%) were another non-Hispanic race (Asian, Native American/Alaska Native, Native Hawaiian/Other Pacific Islander, more than 1 race). Within-person change from current to former smoking was positively associated with SUD recovery: year-to-year change to former cigarette use was associated with a 30% increase in odds of recovery (odds ratio [OR], 1.30; 95% CI, 1.07-1.57), accounting for time-varying covariates and between-person differences. This association remained significant after lagging predictor by 1 year (OR, 1.43; 95% CI, 1.00-2.05) and in the second cohort assessed from 2016/2018 to 2022/2023 (OR, 1.37; 95% CI, 1.13-1.66). In this cohort study, within-person change from current to former smoking was associated with recovery from other SUDs. These results suggest that smoking cessation could be used as a tool to assist recovery processes and improve health among adults with an SUD.