Smoking Against the Odds

New research shows that people stay in recovery longer if they quit smoking at the same time that they quit using other substances. The HRC learns more from Gretchen Clark-Hammond, a tobacco cessation educator at Amethyst, Inc. Amethyst is a program for women in recovery that has integrated tobacco into their addictions treatment approach. It has been a tobacco-free program for four years.

“We know that 85% of people in recovery are addicted to nicotine. People in recovery who quit everything at once stay sober for two to three times longer than people who continue to smoke tobacco.” Gretchen Clark-Hammond is a tobacco cessation educator at Amethyst, Inc. Amethyst is one of a few recovery treatment centers in the state of Ohio that has integrated tobacco into addictions treatment for women in recovery. In February 2010, the program celebrated four years of being tobacco-free.

“In 1999, when I first started at Amethyst, we looked at tobacco use like everyone else. This meant we didn’t look at it. We wished we could do something about it, but we pretended it wasn’t a problem,” says Gretchen.

She offers the analogy that not quitting tobacco is like saying, “Well, it’s too stressful around here. So I will give up alcohol, but I am not going to give up heroin or my abusive relationship with my dealer.”

Gretchen explains that she will ask a smoker: “Are you willing to change yourself first?” This includes both staff and clients. “What we found is that when women can see their relationship with tobacco as an addiction, they get much deeper into their recovery.” Giving up all substance use addictions – including tobacco – at once allows women in recovery to reach a deeper place of connection.

Gretchen asks her clients to examine the physical, social, behavioral, and emotional aspects of tobacco addiction in their lives. She provides education about medications, nicotine replacement therapy, and offers a year-long curriculum on the stages of change developed by the organization. It runs once a week for 90 minutes for a client’s first year. Gretchen also incorporates the use of 12-step programs and a Tobacco Relapse Intervention Program (TRIP) for women who relapse on tobacco.

Four years ago, at the urging of their CEO, Virginia O’Keeffe, Amethyst staff started to move through the organizational change process to become a tobacco-free space.

“For us, it was an ethical issue to be working with women in recovery who were mothers and were smoking around their children. It took a leap of faith to become tobacco-free. They all wanted to kill me at the time,” explains, CEO, Virginia O’Keeffe, “I was not a very popular person for a while. But now we are all healthier.”

“When an agency tries to change anything, it won’t work unless everyone is on board, and this includes staff,” explains Gretchen. Their change process had to begin with staff members, many of whom were smokers.

Talking with Gretchen resonates deeply with my own experiences as a smoker and a person in recovery from substance use.

The night before I interview Gretchen, my daughter Frances, who is five, says, “Mom, when that pack of cigarettes is gone, you should feel free not to buy another pack.” I just bought another pack.

Every morning it is the same. I am not really awake until I have had a cup of coffee and a cigarette. While my kids eat breakfast, I drink coffee on the porch, smoke a cigarette, and say morning prayers. I do this every morning. If I get into the car, I light a cigarette. If feel stressed out, I have a cigarette. If I want to cry, I have a cigarette. If I feel angry, I have a cigarette. If I am happy, I have a cigarette.

I have been in recovery from substance use for 21 months, but I still smoke. No matter what, I do not run out of cigarettes. When I entered recovery, physicians, therapeutic professionals, friends, family, and other people in recovery gave me their blessings. “Keep smoking,” they said. “You are dealing with enough right now.” After interviewing Gretchen, I know that these are misconceptions that only perpetuate my smoking addiction.

Today, talking with Gretchen shows me that these beliefs are myths, and I start to consider the role of smoking in my own life, as a woman, as someone in recovery, and as a mother.

Publication Date: 
2010
Location: 
Rockville, MD, USA