For individuals recovering from substance use disorders, quitting smoking remains a formidable yet crucial step towards achieving long-term health. New research from Flinders University highlights that consistent support and access to a variety of nicotine replacement therapies (NRTs) can significantly assist individuals in recovery in making this vital transition.
The study, published today in the prestigious journal The Lancet Public Health, is the first of its kind to compare the effectiveness of vapes with combination nicotine replacement therapy (cNRT)—including patches, gum, and lozenges—among people leaving smoke-free drug and alcohol rehabilitation facilities.
“Quitting smoking is never easy—but for people emerging from detox, it can be even harder,” says lead author Professor Billie Bonevski, Dean (Research) and Director of Flinders Health and Medical Institute (FHMRI).
Understanding the Challenge
People recovering from substance use disorders are more than twice as likely to smoke compared to the general population, and they face a significantly higher risk of suffering and dying from tobacco-related illnesses. Despite this, effective quit strategies tailored for those navigating addiction recovery have been scarce.
The prevalence of smoking among individuals with substance use disorder (SUD) is alarmingly high, with rates over 84%, compared to 31% in those without SUD. Additionally, these individuals often face complex comorbidities, including respiratory issues linked to smoking and mental health challenges.
The Study’s Findings
The trial tracked over 360 adults leaving detox facilities, who were randomly assigned either a 12-week supply of vapes or a combination of nicotine gum, lozenge, inhalator, and mouth spray. Both groups received Quitline behavioral smoking-cessation counseling.
At the nine-month follow-up, approximately 10% of participants in both groups reported abstaining from smoking—a notable achievement in a cohort where long-term quit rates are typically near zero.
Professor Bonevski emphasizes the importance of offering comprehensive support to individuals in drug and alcohol services who wish to quit smoking. “This isn’t about one therapy outperforming another—it’s about building a system that gives people the best chance to succeed,” she notes.
Implications for Addiction Recovery
The research contributes to a growing body of evidence suggesting that quitting smoking should be an integral component of addiction recovery. With the right support, it is possible for individuals in recovery to overcome tobacco dependence.
“We need to treat tobacco dependence with the same urgency and support we give to other substances,” Professor Bonevski asserts. “Helping people in recovery quit smoking can save lives—and now we know there’s more than one way to do it.”
The study underscores the necessity of integrating smoking cessation into addiction treatment, providing tailored support, and ensuring that all effective nicotine therapies are readily available.
Looking Ahead
The findings from this trial are expected to influence future strategies in addiction recovery programs, emphasizing the need for a multi-faceted approach to smoking cessation. By offering a range of proven tools, recovery programs can significantly enhance the chances of success for individuals trying to quit smoking.
The paper, titled “Nicotine e-cigarettes for smoking cessation following discharge from smokefree inpatient alcohol and other drug withdrawal services: A pragmatic randomized controlled trial,” was authored by Billie Bonevski and a team of researchers and published in The Lancet Public Health journal. The study was funded by the National Health and Medical Research Council of Australia.
Post embargo link: Read the full study
As the conversation around smoking cessation in addiction recovery continues, this study provides a hopeful outlook for those seeking to overcome one of the most persistent challenges on their path to health.
