Understanding nicotine cessation in residential substance use treatment: A new research study at Rosecrance

Despite decades of public health efforts, nicotine dependence remains a persistent issue among individuals undergoing treatment for substance use disorders. Even in environments dedicated to recovery, such as residential treatment centers, smoking continues to be a common and often overlooked habit. A new research study, underway at the Rosecrance Griffin Williamson Campus  in Rockford, Illinois, seeks to address this complex challenge by exploring why individuals continue to use nicotine during treatment, and what might help them quit.

A deeper look at smoking in recovery

The study, titled “Exploring Motivation, Behavioral Patterns, and Barriers to Nicotine Cessation in Residential Substance Use Disorder Treatment,” is being led by Frank Schwartz and Teodora Bozic, first-year medical students at the University of Illinois College of Medicine Rockford. Both psychology majors with a deep interest in mental and behavioral health, Schwartz and Bozic investigate not only the practical barriers to quitting nicotine, but also the psychological and emotional factors that make smoking so difficult to give up during recovery from other substances.

Their qualitative research project focuses on real-world implications, drawing from in-depth interviews and surveys with current nicotine users in residential treatment. By studying behavioral patterns, personal motivations, and perceived obstacles, the researchers hope to offer insights that can improve cessation support in recovery settings.

Research goals and methods

The study is structured around several key objectives:

• Understanding clients’ motivations to quit smoking and what holds them back.
• Investigating why smoking continues during treatment, despite other efforts to achieve sobriety.
• Exploring how individuals perceive smoking in the context of their broader recovery journey.
• Examining how environmental factors, psychological dependence, and withdrawal symptoms influence continued use.
• Evaluating how clients view the effectiveness of current cessation tools, such as nicotine replacement therapy and behavioral interventions.

To collect data, the team will conduct qualitative surveys, 30- to 40-minute interviews and behavioral thematic analysis with 25–35 clients who are active smokers. These sessions will explore clients’ experiences with smoking and quitting, their attitudes about nicotine, and how smoking fits into their daily lives during treatment.

Why this study matters

Cigarette smoking remains one of the leading causes of preventable illness and death in the United States and individuals with substance use disorders are among the highest-risk populations. For many in treatment, quitting smoking may seem like a lower priority compared to overcoming other addictions. However, research shows that continued tobacco use can compromise long-term recovery and significantly reduce life expectancy.

At Rosecrance, tobacco use is treated across the continuum of care. Clients in residential treatment have access to nicotine replacement therapies such as gum and patches, as well as medication-assisted treatment options. Through Rosecrance Therapies, clients may also access transcranial magnetic stimulation (TMS), a noninvasive, FDA-approved treatment that uses magnetic pulses to stimulate areas of the brain involved in addiction.

Still, many clients struggle to quit smoking, an issue that Bozic and Schwartz want to better understand.

“Individuals at Rosecrance are addressing more serious addiction and getting a second chance at life. If you’re using cigarettes, you’re taking some of that away, drastically shortening life and not giving yourself as much of a chance,” Bozic said.

“Smoking has an interesting history because it was medically advertised and historically was more accepted,” Schwartz said. “Nicotine use is up now in part with vaping, and it continues to affect people’s health poorly and contribute to chronic health issues. The chronic health epidemic is what we’re most passionate about.”

Navigating barriers and bias

The study team is also mindful of the challenges that come with qualitative research. Self-reporting bias, selection bias, and the emotional nature of recovery all present limitations. The researchers are employing consistent and neutral interviewing techniques, along with anonymized data collection, to ensure ethical and accurate results.

Looking ahead

This six-month study will conclude with a presentation at a UIC research event, and its findings will be shared with treatment providers and potentially insurance partners. The goal is to develop more effective, personalized strategies to help individuals in recovery quit smoking with strategies that address both practical and emotional aspects of nicotine use.

The research was reviewed and approved by the University of Illinois College of Medicine Rockford Institutional Review Board.