Impact of quitting smoking and smoking cessation treatment on substance use outcomes: An updated and narrative review

Abstract

Background Historically, smoking cessation was thought to negatively impact substance use outcomes among smokers who use other substances. We sought to synthesize recent reports on this association. Methods Google Scholar, PubMed, and Cinahl were searched for studies published from 2006 to March 29, 2016 that reported impact of smoking cessation treatment or quitting smoking on substance use or substance use disorder treatment outcomes in the general population and among those in substance abuse treatment. Studies were grouped by reported impact as follows: “positive” (i.e. improved), “null” (i.e. no change), or “negative” (i.e. worsened). Results Twenty-four studies were included. Eighteen reported the impact of quitting smoking and six reported the impact of smoking cessation treatment intervention, independent of quitting, on substance use outcomes. Eleven studies (46%) reported solely positive impact; four (17%) reported solely null impact; eight (33%) reported mixed positive and null impact by analysis (combined and subgroup, n = 1); substance (n = 4); length of follow-up (n = 2); and comparison group (n = 1). One study (4%) reported mixed negative and null impact by ethnic group. No studies reported increased substance use. Conclusion Smoking cessation does not appear to have a negative effect, and often has a positive effect on substance use outcomes. Smoking cessation advice should be offered, without hesitation, to smokers who report substance use and those in treatment for substance use disorder.

Softening Among U.S. Smokers With Psychological Distress: More Quit Attempts and Lower Consumption as Smoking Drops

“…Likewise, smoking cessation often improves clinical outcomes in people in substance abuse treatment and recovery and can even enhance long-term sobriety. 27–29 In a systematic review and meta-analysis, Taylor et al 30 showed that both in the general population and in a clinical setting quitting smoking is associated with improved positive mood and quality of life, 31 which should reassure smokers with psychological distress as well as their healthcare providers to make quitting one of their priorities.…”

Cigarette smoking quit rates among adults with and without alcohol use disorders and heavy alcohol use, 2002–2015: A representative sample of the United States population

“…Despite concerns, most studies do not find worse outcomes with concurrent smoking and alcohol treatment (see McKelvey et al, 2017 and Thurgood et al, 2016 for recent reviews). In fact, studies suggest greater cravings to use alcohol when smoking cigarettes (see Dermody and Hendershot, 2017 for a review) and smoking may be associated with poorer long-term AUD outcomes (e.g., Weinberger et al, 2015).…”

“…In fact, studies suggest greater cravings to use alcohol when smoking cigarettes (see Dermody and Hendershot, 2017 for a review) and smoking may be associated with poorer long-term AUD outcomes (e.g., Weinberger et al, 2015). Notably, some studies have found improved alcohol and drug outcomes when those in treatment for alcohol and substance use disorders are also treated for tobacco use (McKelvey et al, 2017; Thurgood et al, 2016). While smoking cessation has not been historically included in AUD treatment, and has been discouraged in some cases (e.g., the belief that quitting smoking would be too stressful for adults quitting alcohol), mounting data suggest that efforts to help adults with problematic alcohol use stop using cigarettes, in addition to alcohol, may have positive impacts on health and other alcohol- and smoking-related consequences.…”

Reducing Health Disparities by Tackling Tobacco Use

“…7 Other data dispel the concern about endangering SUD treatment if a tobacco intervention is included. 8 Contrary to the truth, clinicians may also feel that patients with SUD or psychiatric disorders are unable or unwilling to quit. In fact, patients with SUD and psychiatric diagnoses do express interest in quitting, and interventions are effective, albeit achieving lower quit rates than interventions in the general population of smokers.…”