Nicotine Use Is Often Part of the Bigger Recovery Picture
People entering treatment for alcohol or other substance-use disorders often use nicotine as well.
Cigarettes, vaping products, smokeless tobacco and other nicotine products can become deeply connected to daily routines, stress relief, social situations and substance-use patterns.
At Present Moments Recovery, we do not operate a separate nicotine-rehab program.
However, when someone receiving treatment at PMR wants to reduce or stop using nicotine, tobacco cessation can be addressed as part of that person's broader treatment and recovery plan.
That may include education, counseling, behavioral strategies and medication support when clinically appropriate.
Why Address Nicotine During Substance-Use Treatment?
Historically, some addiction programs avoided addressing cigarette smoking because of concern that asking someone to quit nicotine while recovering from alcohol or drugs might make recovery harder.
Research has not supported that concern.
A Cochrane systematic review (opens in a new tab) involving people in treatment or recovery for alcohol and other drug dependence found that tobacco-cessation interventions increased tobacco abstinence and found no evidence that providing tobacco treatment reduced abstinence from alcohol or other drugs.
Another review of adults receiving substance-use treatment (opens in a new tab) found that nicotine-replacement therapy, behavioral support and combined approaches could improve smoking abstinence, although the authors noted that stronger research was still needed.
A separate review examining smoking cessation and other substance-use outcomes (opens in a new tab) found that quitting smoking generally had either neutral or positive associations with substance-use outcomes rather than worsening them.
That does not mean everyone entering addiction treatment must stop using nicotine immediately.
It means tobacco and nicotine use can be discussed as a legitimate part of a person's overall health and recovery plan.
Nicotine Dependence and Withdrawal
Nicotine can create physical dependence.
When someone reduces or stops nicotine use, they may experience symptoms such as:
- cravings;
- irritability;
- difficulty concentrating;
- restlessness;
- changes in mood;
- sleep disruption;
- increased appetite;
- and urges connected to familiar smoking or vaping routines.
The intensity and duration of symptoms vary from person to person.
Nicotine dependence can also involve powerful behavioral patterns. A cigarette after a meal, vaping while driving, smoking during breaks, or using nicotine during stress can become strongly conditioned habits even apart from the physical effects of nicotine.
For many people, successful cessation involves addressing both physical dependence and learned behavior.
How PMR Can Support Nicotine Cessation
For clients already receiving treatment at Present Moments Recovery, nicotine cessation support can be incorporated into the broader treatment plan when the client wants to address it.
Support may include:
Counseling and Recovery Planning
Treatment can explore:
- personal reasons for quitting;
- nicotine triggers;
- stress-management strategies;
- cravings;
- behavioral routines;
- relapse patterns;
- and how nicotine use interacts with other recovery goals.
Nicotine Replacement Therapy
Over-the-counter nicotine replacement options such as nicotine patches and nicotine gum are available from retail stores.
When appropriate, these products can be incorporated into a client's broader cessation plan.
Nicotine-replacement therapy provides nicotine without cigarette smoke and can help manage cravings and withdrawal symptoms during a quit attempt. CDC includes patches, gum and lozenges (opens in a new tab) among FDA-approved medications used to help adults quit smoking.
Prescription Medication
Some clients prefer medication support beyond over-the-counter nicotine replacement.
When clinically appropriate and the client wants this option, varenicline or bupropion may be prescribed as part of the cessation plan.
Both are FDA-approved prescription medications used for smoking cessation.
Medication decisions depend on the individual's medical history, current medications, treatment plan and clinical needs.
Counseling and Medication Can Work Together
Tobacco cessation does not have to rely on willpower alone.
Evidence supports combining behavioral support with medication for many people trying to stop smoking.
A systematic review of adults in substance-use treatment found evidence supporting nicotine replacement, behavioral interventions and combination approaches.
The CDC similarly recommends counseling and cessation medications as evidence-based tools that can be used together.
The best approach depends on the individual.
What About Vaping?
Vaping may look different from cigarette smoking, but many vaping products deliver nicotine and can produce nicotine dependence.
People may also vape much more frequently than they previously smoked because electronic devices can be easier to use throughout the day.
For someone in recovery, useful questions include:
- How often am I using nicotine?
- Do I feel uncomfortable when I cannot vape or smoke?
- Is nicotine connected to stress, boredom or other substance-use triggers?
- Have I tried to reduce my use and found it difficult?
- Do I want nicotine to remain part of my long-term recovery?
A person does not need to answer all of those questions at once.
The first step can simply be noticing the pattern.
Does PMR Require Clients to Quit Nicotine?
This page is not intended to suggest that entering PMR treatment automatically requires someone to stop using nicotine.
Nicotine use and cessation goals should be discussed within the context of the individual's treatment plan, program rules, health needs and recovery priorities.
Some people arrive ready to quit cigarettes or vaping.
Others are focused initially on alcohol, opioids, benzodiazepines, stimulants or another primary substance.
Treatment planning should reflect the person actually entering care—not an assumption that every client has identical goals.
Nicotine Cessation Is Not a Separate PMR Treatment Program
This distinction is important.
Present Moments Recovery does not market or operate a stand-alone:
- nicotine rehab;
- cigarette rehab;
- tobacco detox program;
- or vaping treatment program.
Instead, nicotine and tobacco concerns may be addressed within a client's broader substance-use treatment when appropriate and desired.
That is why the historical PMR page titled around “cigarettes, tobacco and nicotine rehab” no longer accurately describes our current service structure.
We have preserved this subject as an educational resource because nicotine remains highly relevant to many people receiving addiction treatment.
Tobacco Treatment in Behavioral Health Settings
Integrating tobacco cessation into behavioral-health care is increasingly recognized as part of comprehensive treatment.
CDC data from U.S. behavioral-health treatment facilities (opens in a new tab) found that tobacco-cessation counseling was offered by roughly 70% of substance-use treatment facilities surveyed in 2023, while nicotine replacement and non-nicotine cessation medications were offered less frequently. CDC identified integration of cessation support into behavioral-health treatment as an opportunity to reduce tobacco-related disease.
This does not mean every treatment center uses the same approach.
It does reinforce that nicotine dependence deserves attention rather than automatically being treated as unrelated to addiction care.
If You Are Already Coming to PMR for Treatment
If nicotine or tobacco use is something you want to address while receiving care at Present Moments Recovery, talk with your treatment team.
Options may include:
- identifying smoking or vaping triggers;
- counseling and behavioral strategies;
- incorporating nicotine cessation into treatment planning;
- over-the-counter nicotine patches or gum;
- prescription cessation medication when clinically appropriate;
- and planning for maintaining progress after treatment.
Nicotine treatment remains part of the larger recovery plan, not a separate admission pathway.
Frequently Asked Questions
No.
PMR does not operate a stand-alone nicotine or tobacco rehabilitation program.
Nicotine cessation support may be incorporated into broader addiction treatment for clients already receiving care at PMR.
Nicotine patches are an over-the-counter form of nicotine replacement therapy. Clients interested in quitting nicotine can discuss whether nicotine replacement fits their individual treatment plan.
Nicotine gum is also available over the counter from retail stores and may be incorporated into a cessation plan when appropriate.
Varenicline is a prescription smoking-cessation medication. When a client wants medication support, it may be considered and prescribed when clinically appropriate.
Bupropion is another prescription medication used for smoking cessation. It may be considered when appropriate based on the client's individual medical and treatment needs.
Research does not show that providing tobacco-cessation treatment undermines recovery from alcohol or other drugs. Reviews have generally found neutral or potentially beneficial associations between smoking cessation and other substance-use outcomes.
No blanket statement should be made based on this educational page alone. Admissions and program expectations should be discussed directly with PMR based on the individual's situation and level of care.
Research & References
- Thurgood SL, McNeill A, Clark-Carter D, Brose LS. A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment or Recovery. Nicotine & Tobacco Research. 2015. (opens in a new tab)
- Apollonio D, Philipps R, Bero L. Interventions for tobacco use cessation in people in treatment for or recovery from substance use disorders. Cochrane Database of Systematic Reviews. 2016 update. DOI: 10.1002/14651858.CD010274.pub2. (opens in a new tab)
- McKelvey K, Thrul J, Ramo D. Impact of quitting smoking and smoking cessation treatment on substance use outcomes: An updated and narrative review. Addictive Behaviors. 2017;65:161–170. DOI: 10.1016/j.addbeh.2016.10.012. (opens in a new tab)
- VanFrank B, Pasalic E, Oliver BI, et al. Tobacco-Related Clinical Services and Tobacco-Free Policies in Behavioral Health Treatment Facilities — United States, 2023. MMWR. 2025;74:245–251. DOI: 10.15585/mmwr.mm7414a3. (opens in a new tab)
- Centers for Disease Control and Prevention. Quit Smoking Medicines and How to Quit Smoking. (opens in a new tab)