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Smoking Cessation in Recovering Alcoholics

Last Updated April 2022 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

Quitting smoking is difficult for anyone. However, for people who are in recovery from alcohol abuse, it’s an even greater challenge. Smokers in recovery from alcohol abuse may be more addicted to nicotine. As a result, they often smoke more cigarettes.

Path to improved health

Smoking and drinking often go together. However, smokers who are in recovery from alcohol abuse can stop smoking without starting to drink again. While smoking can lead to a stronger craving for alcohol, you have a better chance of staying sober if you quit smoking during or right after alcoholism treatment.

You may be more addicted to nicotine than other smokers. However, very few people succeed the first time they try to quit smoking. Part of the problem may be that you tried to stop smoking on your own. Lots of resources can help you quit. You can get support from friends, family, support groups, nonprofit health organizations, and more.

The most important resource in helping you quit is your doctor. The American Academy of Family Physicians (AAFP) recommends that doctors ask adults about tobacco use. They should advise patients to stop using tobacco, provide behavioral interventions, and provide U.S. Food and Drug Administration (FDA)-approved medicine to help stop smoking.

AAFP recommends adults aged 18 years or older be screened for alcohol misuse. Doctors should provide those engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.

When you stop smoking, you may experience withdrawal symptoms including:

  • Irritability
  • Nervousness
  • Difficulty concentrating
  • Constipation

Counseling, medicine, or both may help you handle the withdrawal symptoms. Ask your doctor what treatment is right for you.

If you feel you won’t be able to quit smoking, don’t give up. There’s a good chance you felt this way when working toward recovery from alcohol abuse. Feeling powerless and admitting you need help is the first step to kicking your smoking addiction. You need to approach quitting smoking the same way you approached quitting drinking – one step at a time. What gave you the strength and courage to give up drinking? The same tools, such as treatment, therapy, group support, spirituality, friends, and family, can help you quit smoking.

Tips to help you quit smoking include:

  • Write down what you like about smoking and what you don’t like about quitting. Then, write down what you don’t like about smoking and reasons to quit.
  • Cut out a few of your favorite cigarettes during the day.
  • For 3 to 5 days, use a notebook to keep track of when you smoke each cigarette. Also, note what you’re doing and how you’re feeling when you reach for a cigarette. Look for patterns in your smoking.

To cope with nicotine cravings and withdrawal, try the following:

  • Ask your doctor about using some form of nicotine replacement therapy, such as a nicotine patch, gum, inhaler, nasal spray, or lozenge.
  • Talk to your doctor about drug therapies to help reduce your cravings.
  • Consider starting an exercise program. Exercise often helps reduce withdrawal symptoms, and it gives you something to do when you get a craving.
  • Check with your doctor to find out about deep-breathing, relaxation, and imaging techniques that can help you cope with stress and cravings.

Things to consider

Smoking is an addiction. It’s as likely to kill you as any other addiction – maybe even more so. People who have been in treatment for alcohol problems are more likely to die from tobacco-related diseases than from alcohol-related problems. In fact, recovering alcoholics who smoke are more likely to get heart disease, lung disease, and cancers of the head, mouth, and throat. They also are likely to die earlier than people who don’t smoke or drink.

Being around smokers can make quitting harder. But giving up any addiction is hard and requires you to make your own choice about what’s best for you and your loved ones. Ask family members and friends not to smoke around you. It gives them the opportunity to be supportive. At first, it may help to stay away from other smokers.

Your body is addicted to nicotine. That means it feels better with the drug than without it. You might be tempted to put off quitting if you are under a lot of stress. Waiting to be stress-free before you try to quit smoking may just be an excuse to avoid facing your nicotine addiction.

Most people gain 5 to 10 pounds when they quit smoking. This is much less of a health risk than smoking. Exercising regularly and eating low-fat foods can help you avoid gaining too much weight.

To prevent relapse, try the following:

  • Avoid doing the things that trigger your cravings for a cigarette. For example, if you always smoke with your morning coffee, try switching to tea instead.
  • Plan ahead and practice how you’ll handle difficult situations. For example, think about the effects of being around friends and family who smoke.
  • Learn how to manage stressful situations and cope with negative feelings like anger, sadness, and anxiety.
  • Look for smoke-free options, such as smoke-free support group meetings. Plan activities where smoking is unlikely, or with family and friends who don’t smoke. Sit in the nonsmoking sections of restaurants.
  • Remember that breaking down and having a cigarette doesn’t mean that you’re a failure. You can climb back on the wagon and try again.

Questions to ask your doctor

  • What if I’ve tried everything and I still can’t quit?
  • If I quit smoking, will that make me want to drink?
  • Is there a chemical connection between alcohol and nicotine?
  • Can the smell of smoke from others make me want to drink or smoke?

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