Quitting smoking may help recovery from substance use disorders

Smoking cessation is associated with sustained recovery from substance use disorders (SUDs), according to a longitudinal cohort study funded by the US National Institutes of Health (NIH).

Patients with SUDs are more likely to smoke and to die from tobacco-related causes than those without SUDs. “Although the health benefits of quitting smoking are well known, smoking cessation has not been seen as a high priority in drug addiction treatment programmes,” noted last author of the study, Dr Wilson Compton of NIH’s National Institute on Drug Abuse (NIDA) in Bethesda, Maryland, US. [JAMA Psychiatry 2025;doi:10.1001/jamapsychiatry.2025.1976]

In this longitudinal cohort study, the researchers analyzed data from the ongoing, nationally representative PATH (Population Assessment of Tobacco and Health) study. A total of 2,652 adult patients with SUDs (mean age, 39.4 years; female, 41.9 percent) were included and followed for 4 years. Almost half of the participants (47 percent) were current smokers, while 44 percent were former smokers and 9 percent were never smokers. Similar proportions of patients were in recovery (48.4 percent) or currently experiencing SUDs or had returned to substance use (51.6 percent).

Smoking cessation, defined as a change in smoking status from current to former, was associated with a 42 percent increase in the odds of being in recovery (odds ratio [OR], 1.42; 95 percent confidence interval [CI],1.18–1.71; p<0.001).

The association was reduced after adjusting for time-varying covariates and between-person differences. However, it remained strong and statistically significant (adjusted OR, 1.30; 95 percent CI, 1.07–1.57; p=0.009).

Additionally, this association was confirmed in a second nationally representative cohort from 2016/2018 to 2022/2023 (OR, 1.37; 95 percent CI, 1.13–1.66; p=0.002).

“There were statistically significant associations for time and mental health, indicating a positive trend in recovery over time [adjusted OR, 1.11; 95 percent CI, 1.05–1.17; p<0.001] and a positive within-person association between improvements in mental health and recovery [adjusted OR,1.04; 95 percent CI, 1.03–1.06; p<0.001],” reported the researchers.

“We now have strong evidence from a national sample that quitting cigarette smoking predicts improved recovery from other SUDs,” highlighted Dr Nora Volkow, Director of NIDA. “It underscores the importance of addressing different addictions together, rather than in isolation.”

These results indicated that smoking cessation could be a tool to assist recovery processes and improve health in patients with SUDs. “Data from the PATH study allow results to be generalizable to patients with current SUDs, including not only those who are actively receiving treatment, but also the millions of adults who do not seek treatment,” noted the researchers.