Addicts in early recovery often follow familiar advice: Don’t worry about giving up nicotine within the first year of sobriety. Nicotine can be just as difficult to quit as drugs or alcohol, and psychologists see patients regularly who say giving it up is not an option.
“That’s a common piece of advice in Alcoholics Anonymous, they say don’t even think about quitting smoking for the first year,” said Gene, a recovering addict whose name was changed to protect his anonymity. “Probably the only place in the world you’ll hear that.”
Gene quit drinking eight years ago, but his pack-a-day smoking habit persisted. He felt a sense of safety in smoking, which provided temporary anxiety relief in early sobriety.
“It definitely felt like something to hold onto,” Gene told the Washington Examiner. “At least I still have this.”
Vaping devices, have come under heavy scrutiny as the number of teens using them has risen to about 3 million.
Lawmakers from both parties favor a legislative crackdown on vaping through measures such as taxing vape products or raising the minimum purchasing age to 21. Such measures could pose an added difficulty for people addicted to drugs or alcohol.
Psychologists and addiction specialists regularly see people in recovery who feel the same way as Gene. Dr. Patrick Kilcarr, a counselor specializing in anxiety and addiction issues at Georgetown University, said people in their first year of sobriety often could not manage to give up nicotine, and it can be even harder to give up than drugs or alcohol. Addicts often feel smoking is the best of the worst in that cigarettes would not ruin someone’s life.
“If you think about the mind of an addict, everything in their life up to that point has been driven by external stimuli. If you look at all of the habits that are not socially condoned, from nail-biting to shooting heroin, one of the least reprehensible would be smoking,” Kilcarr said.
Kate, another addict from Virginia whose name was also changed, told the Washington Examiner that her smoking habit worsened once she entered recovery.
“The minute I got sober, I began chain-smoking. I needed something to do. Anything,” Kate said.
Nicotine has the same neurological effect as a drug or alcohol, making it harder to quit, according to Nike Hamilton, clinical director at the Aquila Recovery Center in Washington, D.C.
“First of all, any addiction involves brain circuitry, and also there’s part of the brain that gives you the dopamine hit,” Hamilton said. “So when people are smoking and vaping and not drinking or using drugs, they’re still getting that buzz.”
Addicts and alcoholics use more nicotine than people without a substance abuse problem, on average, because smoking becomes a coping mechanism in early recovery.
“Going through recovery is enormously difficult, and you can imagine all the repressed depression, anxiety that’s been dealt with whatever the drug of choice is,” Kilcarr said. “Now it’s gone. You can imagine how that’s storming into them. They don’t know what to do.”
More often than not, an addict’s nicotine addiction goes untreated because an alcohol or drug addiction seems so much more critical.
“People who eat sweets may say, ‘I can give up cookies but chocolate, no way.’ It’s the same type of thing. People are like, ‘Give me a break, I’ve given up things that can kill me like fentanyl or cocaine or drinking,’” Hamilton said.
When Kate first got sober at 18, she decided to quit smoking cigarettes, having regularly smoked since she was 16. She said it was hard at first. Kate used a futuristic-yet-clunky vaping device to transition away from cigarettes, and it didn’t stick. Then, she found the Juul e-cigarette and was able to transition away from regular cigarettes during her first year of recovery.
“The Juul really did the job because it hit like a cigarette,” Kate said. “I personally don’t do well with the all-or-nothing approach to quitting smoking.”
Gene gradually transitioned to vaping, too. At first, it did not eliminate the urge for cigarettes, but he would vape when an urge to smoke came on, “and you’d do it, and you realize I kind of don’t want a cigarette right now.”
Mental health professionals said they often see addicts who have transitioned from cigarettes to vaping, but they added that there is little scientific evidence to show that vaping is safer than smoking regular cigarettes.
“There are two sides of this issue. One is, is vaping safer in terms of the compounds that go into your body? Yes,” Kilcarr said. “However, you’re bringing this into your lungs, and you’re infecting your lungs. Hopefully, it’s made well, but we’ve seen sometimes it isn’t.”
Nevertheless, Kate insists that asking a recovering addict to quit smoking or vaping within the first year is asking too much.
“I definitely feel like giving up smoking [in early sobriety] was too much,” she said. “In fact, I increased smoking. I would never suggest that a friend in early sobriety give up smoking or sugar or caffeine in their first year. Those were my saving grace.”