What about rehab for cigarette smokers?

DEAR DR. ROACH »

I have a question in terms of people who are addicted to smoking cigarettes. How come there aren’t any rehabs for people addicted to cigarettes? I heard trying to quit smoking is much harder and more difficult than quitting heroin. Any ideas? — C.A.M.

DEAR READER » Tobacco smoking is incredibly difficult to quit. Many tobacco users have physical dependence to tobacco, meaning they will experience symptoms of withdrawal. Many will also show psychological signs of addiction, which is characterized by compulsive drug-seeking and use, even in the face of negative health consequences.

In-patient rehabilitation can be a very effective way of dealing with addiction. Among those who spent six months in inpatient rehab for drug or alcohol addiction, the success rate (as measured by abstinence) is about 70%. Shorter rehab times mean lower effectiveness.

I think you can probably see the reason in-patient rehab is not used for tobacco smoking: It is a very expensive, very timeconsuming intervention that few can afford. It is used when the threat of physical harm from drugs and alcohol is extremely high.

Cigarette smoking DOES have a high potential for harm. On average, a smoker lives eight to 12 fewer years than a nonsmoker. Quitting smoking successfully is one of the most powerful things a person can do for their health, as most of that difference in life expectancy can come back, and the sooner a person quits, the better. Quitting, even after many years, results in improved function and longevity.

Short of in-patient rehab, there are proven techniques to help a person quit. The combination of behavioral interventions (such as stopsmoking clinics or group classes) and pharmacologic interventions (such as nicotine replacement, bupropion or varenicline) is best.

A person’s regular doctor is the first place to start, but there are experts who can help with tobacco use disorder.

In the United States, continued counseling and support can be accessed through a national program at 1-800-QUIT-NOW