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Should Treatment Facilities crack down on inpatient smoking?

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When signing up for recovery, there are certain expectations that must be met by any one individual, including the willingness to “admit we were powerless over alcohol–that our lives had become unmanageable.” It’s tricky—after all, who wants to admit defeat in a struggle the person doesn’t even realize is occurring until it’s too late. If our experience in recovery is any indicator, not many, right? But you shake off the doubt, acknowledge you have a problem, and decide to enter into a treatment facility. You got this. We take away your cell phone, your credit cards, your phone privileges (for a brief probational period), but you’re alright with it. Why: because we didn’t take away your cigarettes. In fact, many treatment facilities won’t… but what you don’t realize is that treatment facilities may in fact be doing its residents a disservice.

Well, according to one study. Says Timothy C. Durazzo, corresponding author:

“There have been few longitudinal studies that have specifically studied the effects of cigarette smoking on cognitive recovery in alcohol-dependent individuals during abstinence.

To our knowledge, there have been no previous studies that used multiple assessment points to investigate the effects of cigarette smoking on cognitive recovery over the first eight months of abstinence from alcohol. We chose to examine measures of processing speed, learning and memory, and working memory because these abilities have been shown to be adversely affected by alcohol use disorders as well as chronic cigarette smoking.”

Here are the facts:

  • Abusers of alcohol sustain heavy cognitive (think ‘mental’) impairment, even after detoxification
  • A study brings to light the specific areas of cognitive recovery directly affected by light-, moderate-, or heavy smoking
  • In a follow-up study, it was revealed that an alcoholic’s neurocognitive recovery over the course of an eight-month long abstinence program varied, and was largely dependent on one’s smoking status (never, former smoker, regular smoker, as well as a “never smoked” non-alcoholic control group)

The latter research focused on the habits of 133 alcoholic smokers, 89% of which were male, and all of whom participated in assessments after one week, four weeks, and eight months of abstinence, in order to measure cognitive recovery. Durazzo, associate professor in the department of radiology and biomedical imaging at the University of California San Francisco, speaks on behalf of his colleagues when he says:

“We found that, overall, alcohol-dependent individuals as a group showed the greatest rate of recovery on most abilities during the first month of abstinence. Over eight months of sustained abstinence from alcohol, active-smoking alcoholics showed poorer recovery than those who never smoked, on measures of learning, and both former-smoking and active-smoking alcoholics recovered less than never-smoking alcoholics on processing speed measures.”

So, it’s all pretty straight-forward: if you’re a heavy smoker in recovery, the odds are a little more stacked against you than if you had never smoked at all. This doesn’t mean full cognitive recovery following abstinence of drinking while still smoking isn’t possible, but as of this latest study it is speculative—that is, unsure.

A silver lining in all of this is that many Treatment Programs accommodate residents who wish to cease smoking while on facility grounds, oftentimes streamlining access to nicotine patches and gum for a healthier recovery. And why not… after all, “half measures avail us nothing.”