In a study of 200 people who use opioids 97.5% reported current use of at least one tobacco product and most participants said they wanted to quit.
The study appeared in Tobacco Use Insights and surveyed participants at a syringe service program in New Haven Connecticut. Cigarettes were the most common product at 96%, followed by e-cigarettes at 73.5%, cigars at 29.5%, smokeless tobacco at 18.5% and pipes at 16.5%.
A Population That Wants to Quit
The gap between tobacco use and quitting stands out. Among current smokers, 87.5% reported interest in quitting and 37.5% had made a quit attempt during the previous year.
The participants also faced challenges that can affect health and recovery. Their average age was 46.9 years, 66.5% were male and 65.5% were currently homeless. Most participants at 92% screened positive for opioid dependence, while 65% received prescribed medication for opioid addiction.
The researchers led by Sandesh Bhusal and colleagues concluded that harm reduction programs have trusted low barrier contact with people who use opioids and can see the same people repeatedly.
Yet these programs don’t routinely include tobacco cessation support. The researchers discovered an opportunity to add cessation services to syringe service programs and addiction treatment settings where people already receive care.
Why Tobacco and Opioids Overlap
Nicotine and opioids can reinforce each other, while smoking related illness remains a leading cause of preventable death among those with opioid use disorder.
The study also found substantial overlap across tobacco products, with e-cigarette use above 70%. Many participants had already tried to quit without support, which shows that motivation exists even when people lack access to services that could help them succeed.
What Addiction Treatment Programs Can Do
A practical first step involves asking about smoking early in treatment and connecting people who want to quit with nicotine replacement counseling or cessation medications. These tools can fit into an existing treatment plan without disrupting care for opioid use disorder.
Providers can also reach people through settings that already see them regularly. Syringe service programs, methadone clinics and buprenorphine practices often maintain repeated contact with clients while keeping costs low for patients. Adding cessation, counseling or nicotine replacement to those visits allows providers to address tobacco use where people already seek care.
Exploring Treatment Options
Comprehensive addiction treatment can combine medication, counseling and support for related health needs including tobacco use. When comparing rehab centers ask what each program offers and whether its staff address nicotine dependence alongside other forms of substance use.
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