Associations Between Drug Abuse Treatment and Cigarette Use: Evidence of Substance Replacement.

In this study, we investigated whether cigarette smoking increases when substance abusers are in drug treatment. This topic is important because of strong links between the use of tobacco and other drugs and health risk implications. Indeed, the prevalence of cigarette smoking among drug abusers is quite high (Bien & Burge, 1990). Researchers estimate that between 75% and 90% of patients admitted to clinics for treatment of substance abuse disorders are also smokers (Bien & Burge, 1990; Stark & Campbell, 1993). In addition, patients in treatment for drug abuse often state that their cravings for nicotine are stronger than their cravings for the drug for which they are receiving treatment (Kozlowski et al., 1993). Researchers and treatment personnel are quite interested in the effects of treating nicotine addiction while also treating the patient for abuse of illicit drugs. There is the possibility that tobacco consumption increases during cessation of illicit drug use and that enforcement of nonsmoking policies on drug treatment wards could be deleterious to the effectiveness of drug abuse treatment. However, a number of studies designed to determine the effects of nonsmoking policies on drug abuse treatment wards have yet to yield any definitive answers (Campbell, Wander, Stark, & Holbert, 1995; Hurt et al., 1994; Joseph, Nichol, & Anderson, 1993; Karan, 1993)