Opioids and tobacco use

T obacco products and opioids are two of the most widely used addictive substances in the world. In the United States, Arkansas is one of the states with the highest rates of tobacco use and opioid addiction.

The concerning link between these two substances has become increasingly apparent in recent years, as many individuals who are addicted to opioids also use tobacco products.

Tobacco use has long been recognized as a major public health concern and for good reason. According to the Centers for Disease Control and Prevention (CDC), tobacco use is the leading cause of preventable death in the U.S., responsible for approximately 480,000 deaths each year. In Arkansas, over 5,800 adults die from smoking-related illnesses each year. Despite the well-known risks associated with tobacco use, many individuals in Arkansas continue to smoke or use other tobacco products.

Opioid addiction, on the other hand, has become a more recent crisis in the United States, with millions of people becoming addicted to prescription opioids, heroin, and synthetic opioids such as fentanyl.

According to the National Institute on Drug Abuse, opioid addiction claimed the lives of nearly 50,000 Americans in 2019, and Arkansas has not been immune to this epidemic. In fact, the state has some of the highest rates of opioid prescribing and opioid-related deaths in the U.S.

While tobacco and opioid addiction are often discussed separately, there is a growing recognition that these two substances are closely linked. In fact, research has shown that people who are addicted to opioids are much more likely to also use tobacco products than the general population. One study published in the peer-reviewed research journal Addiction found that over 80 percent of people in treatment for opioid addiction were also tobacco users.

There are a number of reasons why tobacco and opioid addiction may be linked. One possibility is that nicotine, the addictive substance found in tobacco, can actually increase the effects of opioids in the brain, leading to a greater likelihood of addiction. Another possibility is that individuals who are predisposed to addiction may be more likely to become addicted to both substances. Additionally, smoking and opioid use may be associated with certain environmental or social factors, such as poverty or mental illness.

Regardless of the reasons for the link between tobacco and opioid addiction, it is clear that addressing both of these issues simultaneously is essential to improving public health. In Arkansas, there are several strategies that can be taken to reduce the rates of tobacco and opioid use. One important strategy is to improve access to evidence-based treatments for both addiction and chronic pain, such as medicationassisted treatment (MAT) for opioid addiction and nicotine replacement therapy (NRT) for tobacco addiction. This can help individuals who are struggling with addiction to achieve long-term recovery.

Another strategy is to increase public education and awareness about the dangers of tobacco and opioids. This can involve targeted campaigns to reach high-risk populations, such as teenagers and individuals with a history of substance use disorders. It can also involve efforts to reduce the stigma associated with addiction and encourage individuals to seek help when they need it.

Tobacco and opioid addiction are two major public health issues in Arkansas and throughout the U.S.

The link between these two substances is increasingly recognized, and addressing both issues simultaneously is essential to improving public health. By improving access to evidence-based treatments, increasing public education and awareness, and enacting evidence-based policies, we can reduce the rates of tobacco and opioid addiction in Arkansas and help those affected achieve long-term recovery. If you find yourself addicted to tobacco, contact 1-800-283WELL to speak to someone who can help you stop smoking.

Online resources and source information:

■ ■ Centers for Disease Control and Prevention (CDC). (2021). Smoking & Tobacco Use: Fast Facts. https://www.cdc.gov/ tobacco/data_statistics/fact _sheets/fast_facts/index.htm

■ ■ Centers for Disease Control and Prevention (CDC). (2019). Extinguishing the Tobacco Epidemic in Arkansas. https://www.cdc. gov/tobacco/stateand community/state-fact -sheets/arkansas/index.html

■ ■ National Institute on Drug Abuse. (2021).

Overdose Death Rates. https://www.drugabuse.gov/ drugtopics/trends-statistics/ overdose-death-rates

■ ■ Arkansas Department of Health. (2021). Arkansas Drug Overdose Data. https://www.healthy. arkansas.gov/programs -services/topics/arkansas -drug-overdose-data

■ ■ Buckland, R., Williams, M., & Veronese, N. (2019).

Cigarette smoking is associated with unhealthy patterns of opioid use among US adults. Addiction, 114(8), 1439-1447. doi: 10.1111/ add.14624

■ ■ Gubner, N. R., Zaller, N. D., Gill, M., Rich, J.

D., & Winkelman, T. N. A.

(2020). Tobacco use and its association with illicit drug use among persons who use opioids illicitly: A systematic review. Nicotine & Tobacco Research, 22(10), 1691-1699. doi: 10.1093/ ntr/ntaa024

■ ■ National Institute on Drug Abuse. (2021).

Medications to Treat Opioid Use Disorder. https://www. drugabuse.gov/ publications/research -reports/medications-to-treat -opioid-use-disorder

■ ■ Fiore, M. C., Jaén, C.

R., & Baker, T. B. (2008).

Treating tobacco use and dependence: 2008 update.

■ ■ Clinical practice guideline. Rockville, MD: U.S.

Department of Health and Human Services, Public Health Service.

■ ■ Campaign for Tobacco-Free Kids. (2021). Tobacco Taxes in the United States. https://www. tobaccofreekids.org/assets/ factsheets/0097.pdf

■ ■ National Conference of State Legislatures. (2021).

Prescription Drug Overdose: State Laws. https://www. ncsl.org/research/health/ prescription-drug-overdose -state-laws.aspx

Earnette Sullivan is the Program Manager for Minority Research Center on Tobacco & Addictions at the University of Arkansas at Pine Bluff, in Pine Bluff, Arkansas.

Earnette Sullivan