Vt. says time for addicts to quit smoking, too

Cigarettes and alcohol addiction are so strongly linked there's a running joke among those trying to quit, says T.K. Blanchard, who's been sober for a year and smoke-free for eight months.
"The joke is that when you see a lot of people smoking outside a church, you know where the (Alcoholics Anonymous) meeting is," the Montpelier 24-year-old says.
Now the state Department of Health wants to put into place a tobacco-free policy at state-funded addiction treatment centers. It's a policy that dozens of other states have already adopted. Vermont plans to put the policy into place July 1. Galaxy cigarettes.
Barbara Cimaglio, deputy health commissioner in charge of Vermont's alcohol and drug abuse prevention program, said the department can set the policy because it licenses the facilities and because the state's Medicaid program provides about 70 percent of the centers' funding.
She said tobacco is one of the biggest burdens of the population of people with addiction or mental illness. And "people say, 'Oh gosh, this poor guy is giving up alcohol and drugs — you expect him to give up cigarettes, too?' Yet we know from a health perspective, this is the thing to do."
At Another Way, a peer-support center where recovering addicts and former psychiatric patients gather, people getting ready for a meeting Tuesday offered a range of perspectives.
Blanchard was among them. He said he spent 50-days at a residential treatment center, Valley Vista in Bradford, last year, and wasn't ready during his stay there to give up tobacco. "That was the last thing I had ... It was a comfort," he said.
But four months into sobriety after leaving the center, he quit cigarettes, too. "The techniques I had learned for staying sober from drugs and alcohol made me ready when I decided to quit smoking," he said.
Others were skeptical, the new policy can work.
"That's going to be a rough one," said Ed Woods, 50. "AA, cigarettes, coffee — they kind of go hand-in-hand."
At the Brattleboro Retreat, a private psychiatric hospital that takes some of its patients under contract with the state, Kurt White, director of ambulatory services, said tobacco use was "vastly more prevalent" among people with substance abuse and mental health problems than among the general population. He said the Retreat has had a smoke-free campus for several years, but will offer nicotine patches to inpatients who arrive with a cigarette habit.
"There's a growing body of evidence that people do better with both their addictions and smoking cessation if they quit everything at once," White said. Often there are "paired associations," he said. "That drink of alcohol might have gone with a cigarette. The cigarette might have been a cue to drinking."
Cimaglio cited hospitals and newsrooms as among the places where smoking once was part of the culture but no longer is.
"This is sort of the last place where we haven't changed the culture," she said of mental health and substance abuse programs. "And there's really no reason we shouldn't do better."