A man smokes a cigarette while another remains broken

Nicotine dependence and substance abuse seemingly go hand in hand. For example, one study estimated that 70-80% of individuals entering a substance abuse program were dependent on nicotine. To further highlight the problem, another study found that those who are successfully treated for drug and alcohol dependence are much more likely to then die of tobacco-related illnesses than drugs or alcohol. (1) Despite these facts, nicotine addiction is often overlooked as the “lesser of two evils” when compared to substance abuse. Here we take an honest look at some fears people in early recovery commonly have about ending nicotine dependence, and what science says about these fears.

What is nicotine dependence?

Nicotine is a naturally occurring alkaloid that is found in tobacco plants. Nicotine is the chemical primarily responsible for the physical addiction that is caused by using A man lights up multiple cigarettes with a matchtobacco products. Nicotine dependence can also occur through the use of various electronic cigarettes (also known as e-ciggs, vapes, etc), which also deliver nicotine. (2)

Does Nicotine cause a withdrawal syndrome?

Using substances that contain nicotine causes a physical dependence on the chemical. Once an individual stops using nicotine, a withdrawal syndrome will occur that contains the following symptoms (3):

  • Irritable, angry, and anxious feelings
  • Difficulty thinking clearly
  • Craving
  • Increased appetite
  • Sleep disturbances

Does ending nicotine dependence increase drug/alcohol craving?

Cravings for drugs and alcohol in early recovery are, simply put, tough. The thought of making these cravings any more pronounced by also quitting nicotine is thus a very real fear. A 2003 study published in the journal Addiction investigated whether quitting nicotine had an effect on cravings. The study found that quitting nicotine simultaneously with drugs and alcohol did not increase the incidence of craving. (4)

Does nicotine dependence have an effect on early recovery rates?

Another common fear is that quitting nicotine simultaneously with drugs/alcohol will decrease success rates in achieving sobriety. Studies show this is not only wrong, but the opposite is actually true. One study showed that those who quit smoking along with drugs/alcohol had improved recovery rates. The study showed that those treated for both tobacco and substance abuse had 37% recovery rates, versus 31% for those treated for alcohol/drugs only. (5)

What effect does smoking have on relapse and long-term recovery?

The belief that smoking is the “lesser of two evils” may not be as true as once thought. Smoking after being discharged from treatment has been cited as a factor for increased risk of relapse by two separate studies. (6) (7) Another study sought to see the relationship between smoking and those who had left treatment five yeas prior. Overall, the study found that quitting smoking was associated with a reduced risk of relapse. (8)

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So what does this mean?

Simply brushing smoking under the rug while undergoing treatment for addiction simply is not as harmless as we once thought. The reality is, tobacco is a major cause of death each year in the United States, and those in recovery have high rates of tobacco use as mentioned earlier. (9) Making the decision to quit smoking simultaneously with entering sobriety not only increases our chances of successful recovery, it unquestionably will improve our quality of life.

Final Note

This article is intended for those considering a new way of life, free of the pain of drug and alcohol addiction. For more information on recovery and anyone seeking help with addiction and substance abuse problems, please call True Recovery at (844) 744-8783 or visit us online.


  1. http://www.williamwhitepapers.com/pr/2011%20Smoking%20and%20Addiction%20Recovery%20%28For%20People%20in%20Recovery%29.pdf
  2. https://www.medicalnewstoday.com/articles/240820.php
  3. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm
  4. https://www.ncbi.nlm.nih.gov/pubmed/12814497
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826972/
  6. https://www.ncbi.nlm.nih.gov/pubmed/12915172/
  7. McCarthy WJ, Collins C, Hser YI. Does cigarette smoking affect drug abuse treatment? Journal of Drug Issues. 2002;32:61–80.
  8. https://www.ncbi.nlm.nih.gov/pubmed/17364419/
  9. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm