Integrating Tobacco Use Disorder Interventions in Addiction Treatment: A guide for addiction treatment clinicians and programs

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Between 65-87% of patients in addiction treatment smoke tobacco, compared to about 21% of the general population. These high rates of tobacco use contribute to significant patient suffering and early death. Over 53% of people with substance use disorder (SUD) die of tobacco-related causes. Most of these deaths occur before age 60, while only about 30% of the general population die of tobacco-related deaths and typically after age 70.  Highly effective interventions that target tobacco use are available; however, they are not sufficiently integrated into addiction treatment programs.

Common misconceptions have limited the use of tobacco use disorder interventions in addiction treatment settings. Many clinicians mistakenly believe that encouraging patients to address their tobacco use disorder may disrupt the treatment for other SUDs. However, research has clearly demonstrated the efficacy of treating tobacco use disorder in parallel with other SUDs.

Providing evidence-based treatment for tobacco use disorder during addiction treatment is associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Yet, in a recent national-level survey study, only 64% of the patients in substance use disorder (SUD) treatment were screened for tobacco use, and less than one in four facilities offered evidence-based pharmacotherapies to help them quit tobacco.

Continued tobacco use corresponds to poorer addiction treatment outcomes, including a higher likelihood of relapse to substance use. The integration of tobacco-related services into addiction treatment can improve treatment outcomes, promote recovery, and reduce the well-established harms of ongoing tobacco use, including tobacco-related death and disease.