Quitting Smoking Linked to Better Recovery From Substance Use Disorders

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People who are working to recover from a substance use disorder (SUD) often also smoke cigarettes, but quitting smoking is not always addressed in recovery programs. In a study published in JAMA Psychiatry, investigators found that quitting smoking was linked to better chances of recovery from other substance use problems.

“Although the health benefits of quitting smoking are well-known, smoking cessation has not been seen as a high priority in drug addiction treatment programs,” said senior investigator Wilson M. Compton, M.D., deputy director of National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. “This finding bolsters support for including smoking cessation as part of addiction treatment.”

Although cigarette smoking is on the decline, smoking continues to be the leading preventable cause of morbidity and mortality in the U.S. — with people with SUDs exhibiting a disproportionately high likelihood of dying from smoking-related causes. Recent estimates show that 35.8% of the 48.5 million people in the U.S. with an SUD currently smoke.

Investigators used data from more than 2,600 adult patients with a history of SUD enrolled in the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Patients were assessed annually over the course of a four-year period.

The main outcome was SUD recovery, which was determined using the Global Appraisal of Individual Needs–Short Screener SUD subscale, measured as high lifetime SUD symptoms (four to seven symptoms) and sustained remission, or high lifetime SUD symptoms with any past-year symptoms.

Among the cohort, the mean age was 39.4 years, 41.9% were female, and most (63.1%) were White. Cigarette smoking status was classified as never, former or current. Within the group, almost half (47.2%) were current smokers, 44.3% were former smokers, and only 8.5% never smoked.

The team found that when people transitioned from being current smokers to former smokers, their odds of SUD recovery improved by about 30%. In other words, quitting cigarettes wasn’t just good for overall health — it was also associated with higher chances of staying in remission from substance use problems.

Importantly, this finding held true across different types of analyses, including a second large group of participants followed from 2016 to 2023.

Like all research, this study had some limitations to keep in mind. Investigators noted they did not have detailed information about whether participants were receiving specific treatments for substance use disorders, such as counseling or anti-craving medications. They did account for whether people had medical visits or used other medications, but some important factors may not have been captured.

The study also relied on participants’ own reports of their behaviors, which can sometimes be inaccurate. In addition, recovery was measured only as complete abstinence from substance use, so the findings may not apply to people who are improving their health through harm reduction strategies, such as cutting down rather than quitting entirely.

Investigators encourage future research to focus on how quitting smoking may support different kinds of recovery, not just abstinence.

The takeaway: For people in recovery, addressing smoking may play an important role in supporting long-term success. Treatment programs that include smoking cessation could offer patients a stronger path toward sustained recovery.

“We now have strong evidence from a national sample that quitting cigarette smoking predicts improved recovery from other substance use disorders,” said Nora Volkow, M.D., director of NIDA. “It underscores the importance of addressing different addictions together, rather than in isolation.”