Treatment Programs

For Addiction Rehabilitation Centers:

Up to 65% of persons admitted to addiction rehab facilities are addicted to nicotine as well as alcohol and other drugs. Unfortunately, most rehab centers make special arrangements for their smoking clients so that they can continue smoking while in treatment for their other addictions.

Most professionals are in agreement that this practice is foolish. A Health and Human Services Panel has stated, The failure to treat tobacco use, the chief cause of preventable disease and death, constitutes an inappropriate standard of care”.

Many addiction treatment programs are fearful of plummeting registration and retention rates if they become smoke free. Their counseling staffs fear the impact on their time and their therapy if they are required to treat smoking as an additional addiction. Experience shows that both fears can be addressed by the integration of smoking cessation strategies into existing treatment plans at rehab centers. Counselors are often surprised to see the benefits that result from treating all addictions simultaneously.






“I Don’t Smoke!” can serve as a treatment plan and/or an aftercare plan... AND A READING ASSIGNMENT...

Be a Part of the Solution:

During twelve years of directing smoking cessation activities at Onsite Workshops, a treatment and training center, we were pleasantly surprised to find that most clients who were in therapy for a variety of other issues had little difficulty stopping their use of nicotine. There were exceptions, of course, but for the most part they did not require medical detoxification and their addiction did not interfere with their other ongoing therapeutic work.

It became clear that the lack of nicotine in these individuals actually enhanced the work they were doing. We found that blending smoking cessation with the other presenting issues can be complimentary and add to the overall dynamics of the healing process. Blending is the key word. Smoking cessation integrates just fine with other smoking and non-smoking clients’ work in group therapy.

This approach adds to, rather than interferes with, any existing program. Our counselors agreed that therapy became more potent, accelerated and successful.

The Obstacles:

The addiction treatment field, as well as many, many other healthcare programs mostly ignore nicotine addiction in their patients/clients. A Health and Human Services panel has stated: The failure to treat tobacco use, the chief cause of preventable disease and death, constitutes an inappropriate standard of care”.

So what should be done? It is almost impossible to expect a busy treatment facility to suddenly decide to become non-smoking. Many treatment programs have debated the risks and benefits of implementing a smoking cessation program. But where do you start? And what are the obstacles? Here a few answers:

  • There is anger and resistance on the part of the smoking staff and the younger adult and adolescent patients.

  • Potential referrals/referents may not call

  • The place will go wacky with a bunch of people in nicotine withdrawal.

  • Clinical staff believes there is a different approach and too much time needed to treat nicotine addiction. It will deter from the primary programs. (Actually, when feelings formerly medicated by nicotine begin to surface, therapy becomes more potent.)

  • The positive outcome in many smoking cessation programs is less than 50% at three months and less than 30% at one year. (These numbers are improved by using more than an informational/task program on the dangers of smoking.)

How can it get started? Nicotine dependence deserves recognition as the life, and quality of life, threatening illness it is. The facility staff need to embrace the concept that smoking cigarettes and other manifestations of nicotine dependence is a treatable addiction.

The first steps can be fast and easy. They are awareness steps.

Be a Part of the Solution...

Suggested First Steps


Perhaps, do no more than physically mark the outside of the smokers medical record; list nicotine addiction on the problem list; code out the inside of the patients/clients chart with whatever DSM-IV designation(s) are appropriate:

  • 305.90 Nicotine Dependence

  • 292.9 Nicotine related disorders

  • 292.0 Nicotine withdrawal

  • Issue a copy of "I Don't Smoke!” It can be used for private study by the patients/clients

  • Train staff on the concepts and tasks of recovery used in the book.

Integrate the concepts and tasks into treatment plans:

  • Reading assignments can be given out.

  • Checklists in the book are good for Group and Nicotine Anonymous discussions.

  • Use the “Dear John” letter and “The Funeral” as experiential group exercises. Smokers and non-smokers benefit by saying goodbye to their addictions.

  • Build appropriate parts of the aftercare plan from the book per the therapist’s directions.

  • There are many additional ideas in the book

Or simply give a copy to the patient upon discharge and so note in their record. Or place the book in your bookstore. Whatever you do can add to what is presently being done for nicotine addiction in your facility.

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