
As someone who dedicates his life to advocating for treatment for those struggling with addiction, and as someone who is personally addicted to cigarettes...
New York Alcohol and Substance Abuse Service officials announced a new proposal last month that would require all New York State drug treatment centers to help their patients quit smoking.
The plan, which is slated to take effect next year, would require centers to offer nicotine replacement therapy, including nicotine gum and patches, to all smokers, along with the counseling and other services already available to treat addiction. For those lacking health insurance, the nicotine therapy will be free.
So far, so good. But the regulations would also require that treatment centers be smoke-free. And for many who seek drug treatment that could be a big impediment.
Officials estimate the new rules would affect 110,000 patients on any given day. Approximately 92 percent of those in alcohol and other drug treatment programs are cigarette smokers, according to official estimates.
As someone who dedicates his life to advocating for treatment for those struggling with addiction, and as someone who is personally addicted to cigarettes, I have mixed feelings about the proposal. I certainly applaud efforts to help people quit smoking. But I'm worried that the smoking ban may deter some smokers who are hoping to quit other addictions from seeking help.
Helping smokers kick the habit will save lives and should be applauded. More than 400,000 people in the United States die prematurely from cigarettes each year - more than from all other legal and illegal drugs combined. It's important that public health officials and treatment providers acknowledge that cigarettes and the nicotine they contain - a legal drug - can cause as many health problems as the more demonized illicit drugs. A proactive strategy to help people quit smoking is a positive initiative and it should be supported. By offering free treatment, we'll surely help some people kick the cigarette habit and prolong many people's lives.
But the second piece of the new regulations would be more problematic. Prohibiting smoking at treatment centers may sound like a laudable public-health objective. But I have no doubt the policy would discourage some people from seeking needed treatment. Some addicts may want treatment for their dependence on drugs like alcohol, heroin or cocaine, but they may not be ready to quit smoking.
Do we really want to set up barriers that will keep these people from seeking treatment if they are unable or unwilling to quit cigarettes?
Not everyone wants to - or is able to - abstain from all drugs all at once. If someone is ready to get off heroin but isn't ready to quit cigarettes, we shouldn't discourage him or her from getting help because of a rule that prohibits them from smoking during treatment.
Much of the new statewide campaign to help people quit cigarettes is groundbreaking and life-saving. It is smart, cost-effective and humane to offer people free assistance and tools for quitting this harmful habit. But a smoking ban at drug treatment centers would be a step in the wrong direction. We need open doors that encourage people to get help for their problems, not inflexible rules that drive people away from life-saving programs.
It would be great if we lived in a perfect world, where addicts could quit all the harmful drugs they were using at the same time, never to relapse. But the reality is that some may need to quit different drugs at different stages, and relapse is a common experience when dealing with addiction.
Let's meet people's specific needs, respect their particular limitations and not let perfect be the enemy of good.