Should You Quit Smoking When Recovering From Addiction?

You’ve probably heard the old joke, “What do you do if you can’t find your AA meeting? Look for the church with people smoking outside.” The chain-smoking, coffee-drinking recovering alcoholic is a familiar stereotype and there’s even some research suggesting it has a valid basis. 

The Research

A study of AA members in the Nashville area found that AA members really do consume significantly more coffee and cigarettes than the average person. The study found that nearly 89 percent of respondents drank coffee, often four cups a day or more, compared to only 64 percent of Americans overall. However, moderate coffee consumption is probably fine and may even have potential health benefits. Read the post “Is Caffeine Bad for Addiction Recovery?for more on this topic.

Smoking, however, is another story. The same study found that nearly 57 percent of surveyed AA members smoked, and most of them smoked heavily. Meanwhile, only 14 percent of Americans in the general population smoke. That’s a massive difference. If you’re recovering from a substance use disorder and you smoke, there are several reasons you should seriously consider quitting.

Smoking Compounds the Health Risks of Substance Use

By now, most people are aware of the major health risks of smoking, including lung cancer, mouth and throat cancer, emphysema, COPD, respiratory infections, and cardiovascular disease, including coronary heart disease and stroke. Lesser-known risks include cancers of the liver, esophagus, bladder, kidney, and colon, as well as increased risk of type 2 diabetes, inflammation, poor immune function, and rheumatoid arthritis. 

Many of these health problems are similar to those caused by various substances. Alcohol and stimulants such as cocaine, for example, significantly increase your risk of heart disease and stroke. Heavy drinking has been linked to many of the same kinds of cancers, particularly esophageal, stomach, liver, and colon cancers. Excessive drinking also increases your risk of type 2 diabetes. 

Additionally, it’s important to note the association between smoking and inflammation. Recent research suggests that inflammation may play a leading role in many forms of depression. Depression is a common co-occurring disorder among people with substance use issues and it is frequently a challenge for people in the early months of recovery. Smoking may contribute to depression as well. 

Individuals that are just starting out in recovery may already have an increased risk for many of the health issues noted above. Chances are that smoking will only make them worse. In 2017, more than 70,000 people died of drug overdoses, 88,000 died of alcohol-related causes, and 480,000 people died of smoking-related causes. That’s one in five deaths in America attributed to smoking. From a health and longevity perspective, it doesn’t make much sense to go to the trouble of quitting drugs and alcohol but continuing to smoke. 

Smoking May Increase Your Risk of Relapse

Some people have the attitude that while smoking may be bad for them, it’s the lesser of two evils because it helps them stay sober. However, this may not actually be the case. A large study, conducted by researchers from Columbia University, comprised of more than 34,000 people, found a strong correlation between smoking and the risk of relapse to drug and/or alcohol use. 

Researchers looked at three years’ worth of data gathered by the National Epidemiologic Survey on Alcohol and Related Conditions. Data showed that smokers were almost twice as likely to relapse over the course of three years compared to non-smokers–11 percent and 6.5 percent, respectively. Additionally, there is some indication that quitting smoking can improve your chances of staying sober. Among those who started out smoking in recovery from addiction, but then quit, their risk of relapse was only eight percent. 

Note that this study only shows correlation and not causation. Still, some possible explanations exist as to why smoking may lead to relapse. One reason states that smoking is a significant cause of inflammation, which may cause depression, a major risk factor for substance use. Another possible explanation is that smoking is often experienced as a trigger to drug and/or alcohol use, as the behaviors often have a close association.

Smoking Is a Common Trigger

Noted above, smoking is much more common among AA members than in the general population. It’s unlikely that many of those people decided to start smoking after they stopped drinking. Additionally, it’s highly likely that smokers typically drank and smoked at the same time. Cigarette smoke has a distinctive smell, which makes it an especially powerful trigger since our sense of smell is closely connected to emotional memory. Lighting a cigarette may make you feel like you should also be having a drink.

Smoking May Mask Symptoms of Mental Illness

In the previously discussed Nashville study, smokers typically reported that they smoked to relieve negative emotions and give them more energy. As noted above, there is a large overlap between major depression and substance use disorders. People who rely on mutual aid groups such as AA and NA alone typically don’t get help for any co-occurring mental health issues. It’s possible that their symptoms of negative mood and fatigue are related to depression. Smoking to self-medicate these symptoms may prevent you from seeking the help necessary to create a sustainable solution. If you are experiencing symptoms of depression, including loss of interest in things you used to enjoy, disturbed sleep, physical aches, irritability, weight changes, feelings of hopelessness, or thoughts of suicide or death, you should talk to your doctor or therapist about depression.

Need Support?

We all know smoking is bad for us but many people continue to smoke anyway. Individuals that are recovering from addiction should take potential risk factors of smoking seriously, as some of them can increase vulnerability to relapse. Quitting smoking is tough and few treatment programs address it specifically. However, you can choose to quit and there are many resources to help you if you decide to do so. At Steps Recovery Centers, we know that recovery means addressing the whole person and making the necessary changes to support a life free from addiction. We are committed to using our holistic treatment approach as a way to support our clients long after graduation from our program, in order to support their long-term sobriety. To learn more about our alumni services, call us today at 385-236-0931.


Steps Recovery Center realizes the importance of maintaining a safe and effective environment for our clients and staff. As such, we are actively following all Centers for Disease Control (CDC) and the World Health Organization (WHO) Guidelines. The additional measures we take at Steps Recovery Centers include implementing the following protocols: admissions screening and testing, coronavirus infection control plans, providing education to clients and staff, and daily, effective screening of all employees and clients for Coronavirus symptoms. To ensure we protect and promote the health and wellbeing of our staff and clients, we will continue to monitor any developing updates to COVID-19, including exposure statistics in the community and guidelines provided by the Utah Department of Public Health.