A Canadian study shows tackling cigarette addiction also reduces opioid abuse.
The six-month research project, conducted with 80 inner-city homeless and poor people, provided free counseling for a range of needs, along with nicotine replacement therapy in the form of gum, patches, or inhalers. The comprehensive approach to reducing their nicotine addiction led participants who stayed in the program to cut their daily cigarette consumption from an average of 20.5 cigarettes a day to 9.3.
The same participants also reported an 18.8 percent decrease in their use of illicit drugs like fentanyl and heroin.
“We need to understand that opioid addiction does not occur in isolation,” said Smita Pakhalé, a respirologist at The Ottawa Hospital who also directs The Bridge, a community center where she led the study.
“Tobacco is the king of addictions, it’s the strongest addiction, and it causes structural changes in your brain, in the receptors, and it amplifies the response,” Pakhalé said as she explained the neurobiology of smoking.
Smoking is nearly universal among Ottawa’s homeless and vulnerable populations, according to another study of 858 drug users. The 2013 findings showed 96 percent of the participants smoked every day, compared to only 9 percent of the city in general.
“Mental health issues, poverty, housing, food insecurity, trauma—all of these are related to addictions,” Pakhalé said. “So you need an approach that addresses the whole person rather than just the opioid or just the cigarette or just their diabetes.”
One addiction reinforces another, and though many of those surveyed wanted to quit smoking, there is a tendency to see smoking as a minor issue in the mix of housing and mental health needs. The Ottawa study offers hope that reducing common smoking opens the way to treating other serious addictions.
A positive achievement in quitting cigarettes could be the first major baby step.