Smoking cessation in people with alcohol and other drug problems.

BACKGROUND: People who consume alcohol and other drugs are at particularly high risk of harm from smoking, yet tobacco use is commonly neglected in this patient group.
OBJECTIVE: The objectives of this article are to increase awareness of the high risk of tobacco-related harm in people who consume alcohol and other drugs, identify the barriers to quitting and provide practical guidelines to assist quitting. DISCUSSION: People who are dependent on alcohol and other drugs are far more likely to die from a smoking-related illness than from their other drugs. Most are motivated to quit smoking; however, their quit rates are lower than in the general population. Substance users who also smoke can usually be treated with similar behavioural and pharmacological treatments as others who smoke, but generally require more intensive and longer treatment. Quitting smoking at the same time as undergoing other drug treatment does not undermine drug treatment outcomes and may improve them. Smoking cessation should be integrated into the routine care of patients who consume alcohol and other drugs.