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Stop the Smoke

July 11, 2008
by Gary Enos
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I have to admit to being a bit surprised about the results of our latest completed Web poll, on treatment center policies toward smoking. Three of every five respondents to the survey said their addiction treatment program does not require clients who smoke to participate in a smoking cessation program. The idea of behavioral health facilities addressing smoking head-on is hardly brand new. A good number of psychiatric hospitals began taking steps to make their environments smoke-free earlier this decade, and integrating tobacco cessation into alcohol and drug addiction treatment was one of the earliest feature topics we covered in Addiction Professional. I found it interesting that none of the respondents who said their facilities did not require participation in smoking cessation activity offered any written explanation. So, by default, the floor goes to the one respondent who rebuked their approach: That person wrote, "Nicotine dependence is drug addiction. It is the height of hypocrisy and double standard to have people claim to be in recovery and sober from drugs while they are puffing away on a drug that kills more people than all other drugs, alcohol, HIV and suicide combined."



What I would say (if I could speak to 'that person'...or any other person who agrees with 'that person') to that person:
Nicotine dependence may be an 'addiction' but it is not the addiction we treat when a person comes through our (clinic) doorsthey generally have been arrested for drunk/impaired driving, caught drinking/drugging on the job, have been confronted by an angry parent/spouse/significant other for their excessive and problematic drinking/drugging, and on. Our clients have not come to an alcohol/other drug treatment facility because their 'tobacco addiction' is problematic for themselves/significant others, employers, etc...they don't get fired/arrested/etc. due to tobacco!
Tobacco is NOT a 'mind-altering, mood-changing substance' when compared to alcohol, cocaine, heroin, and other such drugs.
If someone ends up seeking alcohol/drug treatment from me I don't think it's my business to treat them for tobacco use/addictionthe person did not ask me/us to fix his smoking habit. I also don't treat 'court-ordered' alcohol/drug clients for their tobacco use (I could go on, but I think I've pretty much made my point).
Clients often come to our agencies for alcohol/drug treatment and have other lifestyle issues that are negatively impacting their lives but I/we don't insist they get treated for such simply because they've asked for alcohol/drug treatment. I certainly would make them aware for the negative impacts those 'issues' have in their lives, and that they *may* wish to consider making changes re: such, but I don't believe it's my 'duty' to insist they correct those behaviors/issues.
No...I don't see any 'hypocrisy' when an alcoholic/addict gets treated for alcohol/drugs but not for tobacco.

Jim K...MSW...20+ years working in the field of alcohol/drug abuse and addiction

Gary Enos


Gary Enos

Gary A. Enos has been the editor of Addiction Professional since its inception. He also...

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