Strategies for Sustaining Smoke-Free Living Post-Rehabilitation

For individuals recovering from substance use disorders, quitting smoking is often a challenging yet essential step towards long-term health. Recent research from Flinders University highlights the importance of consistent support and access to various nicotine replacement therapies (NRTs) for those in recovery. This innovative study, published in the peer-reviewed journal *The Lancet Public Health*, compares the efficacy of electronic cigarettes (vapes) against combination nicotine replacement therapy (cNRT), which includes patches, gum, and lozenges, among individuals discharged from smoke-free drug and alcohol rehabilitation facilities.

Professor Billie Bonevski, Dean (Research) and Director of the Flinders Health and Medical Institute (FHMRI), emphasizes that quitting smoking is particularly difficult for individuals emerging from detoxification. "People recovering from substance use are more than twice as likely to smoke compared to the general population and are significantly more vulnerable to tobacco-related illnesses," she stated. Despite the substantial health risks associated with smoking, effective quitting strategies tailored to those navigating addiction recovery have historically been scarce.

The study tracked over 360 adults leaving detox facilities who were randomly assigned to receive either a 12-week supply of vapes or a combination of nicotine gum, lozenges, inhalators, and mouth sprays. Both groups also received behavioral smoking cessation counseling from Quitline. At the nine-month follow-up, both groups reported an abstinence rate of approximately 10%. This figure, while modest, represents a significant achievement in a demographic where long-term quitting rates typically hover near zero.

"Our findings underscore the critical need for comprehensive support systems within drug and alcohol services for those aiming to quit smoking," said Professor Bonevski. "This isn't about one approach being superior to another; it’s about creating a framework that maximizes the chances of success for individuals in recovery. Access to a variety of established cessation tools is paramount."

The research supports the notion that smoking cessation must be integrated into addiction recovery programs. The authors advocate for treating tobacco dependence with the same urgency afforded to other substance dependencies. "Helping individuals in recovery quit smoking can save lives," stated Bonevski, reaffirming the necessity of diverse support mechanisms.

The study, titled *Nicotine e-cigarettes for smoking cessation following discharge from smokefree inpatient alcohol and other drug withdrawal services: A pragmatic randomized controlled trial*, was co-authored by a team of experts including Jane Rich, Dan I Lubman, and others, and can be accessed through DOI: 10.1016/S2468-2667(25)00101-X. Funding for the trial was provided by the National Health and Medical Research Council of Australia under Project Grant GNT1160245. The study acknowledges the contributions of trial participants and Quitline Victoria staff in its execution.

These findings contribute to an expanding body of evidence asserting that quitting smoking should be a fundamental aspect of addiction recovery. With adequate support, recovery from smoking addiction is indeed attainable, paving the way for healthier futures for individuals overcoming substance use disorders.