QUITTING smoking may significantly improve the chances of long-term recovery from alcohol or other drug addictions, according to a large US study. Adults who stopped smoking after a history of substance use disorder were substantially more likely to sustain remission from their non-tobacco addictions.
Tobacco use is far more common among people with substance use disorders than in the general population, yet smoking cessation support is often absent from addiction treatment programmes. This research suggests that tackling smoking alongside other addictions could strengthen recovery outcomes and should be viewed as an integral part of treatment, rather than a secondary goal.
Researchers analysed data from 2,652 adults aged 18 and over who were enrolled in the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Participants all had a history of substance use disorder and were followed for four years between 2013 and 2018, with annual assessments of smoking status and substance use. Moving from being a current smoker to a former smoker was linked to a 30% higher likelihood of sustained recovery from non-tobacco substance use disorders (odds ratio 1.30, 95% CI 1.07 to 1.57). The association persisted after accounting for multiple confounding factors, and similar results were observed in a separate national cohort assessed from 2016 to 2023. Sensitivity analyses, including a one-year lag in predictor variables, continued to show a positive effect of quitting smoking on recovery odds.
Clinically, these findings support incorporating smoking cessation into standard addiction care to potentially boost overall recovery rates. Addressing tobacco use may have the dual benefit of reducing smoking-related health risks and improving the likelihood of remission from other addictions. While this observational study cannot prove causation, its scale and representativeness strengthen the case for integrated treatment approaches. Further research is needed to confirm causality, identify the most effective cessation strategies for people in recovery, and explore whether early intervention on tobacco use can reduce relapse rates for other addictions over the long term.
Reference
Parks MJ et al. Cigarette smoking during recovery from substance use disorders. Jama Psychiatry. 2025;DOI:10.1001/jamapsychiatry.2025.1976.
