If I quit everything at once, will I cave faster?

Not necessarily. Several studies show highly motivated people succeed better in simultaneous withdrawal than sequential. The risk mostly comes from lack of support, not the number of substances. With addiction-centre follow-up, often the most effective option.

My therapist says to keep tobacco 'not to overload'. Good advice?

Now contested. Recent recommendations (NICE, addiction specialists) encourage simultaneous quitting. If you feel ready, a specialist opinion can help.

And the e-cigarette in all this?

Vape can be a bridge to quit tobacco, especially if you combine tobacco + cannabis. Risk: staying dependent on nicotine long-term. Use as a step, not a final destination.

I use cocaine occasionally. Does it change my tobacco strategy?

Not drastically. Cocaine and tobacco are often socially associated, creating cross-triggers. Anticipate these situations during your quit.

I'm on Subutex (buprenorphine). Can I still take nicotine patches?

Yes, no interaction between buprenorphine and nicotine substitutes. Same for methadone. You can quit tobacco serenely alongside opioid substitution.

My circle discourages me: 'You're already quitting alcohol/cannabis, don't add tobacco.' What to do?

Your circle is likely well-meaning, but clinical experience shows that simultaneous quitting works well in motivated profiles. Discuss with an addictologist (addiction centre) for professional advice and structure your choice.

Smoking and polyaddiction: quitting when you combine alcohol, cannabis or other dependencies

80 % of people with alcohol dependence smoke. Should you quit everything at once? Here are the recommendations based on your profile and co-consumption.

June 8, 2026 Aria

The scientific basis on quitting smoking was reviewed on a voluntary basis by Pr. Bertrand Dautzenberg , a tobacco specialist, in order to rule out gross, potentially dangerous errors. It reflects positions commonly shared by health professionals and health agencies, without always corresponding exactly to his thinking or his practice. He is not the author of this text; he has only carried out a vigilance review of it.

You smoke, and drink more than you should. Or you smoke and use cannabis regularly. Or both. You're not alone — most people addicted to tobacco combine it with one or more other substances. The recurrent question: where to start? No single answer exists, but clear principles depending on your profile.

What research now says

For a long time, withdrawals were separated: 'Alcohol first, tobacco later.' This approach is largely challenged.

Smoking cessation can perfectly be proposed alongside alcohol withdrawal, with any substitution treatment available. Keeping tobacco on the pretext of 'not overloading' is a poor signal.

NICE and addiction specialists, current recommendations

80 % of people dependent on heroin are also dependent on tobacco and/or alcohol. And smokers are 5 times more likely than non-smokers to use another psychoactive substance.

ASH UK / Public Health England data

Typical profiles

Tobacco + alcohol: what first?

Frequent question. Modern answer: simultaneous is preferable in most cases.

Tobacco + cannabis: nuanced order

Tobacco + opioids: substitution priority

Tobacco + gambling/screen/sugar: behavioural addictions

Recap table

Co-addiction	Quit at the same time?	Priority
Alcohol (moderate-severe)	Yes, simultaneous preferred	Both
Cannabis (daily)	Not ideal	Cannabis first
Cannabis (festive)	Yes, simultaneous possible	Both
Opioids	Tobacco later	Opioid substitution first
Cocaine/MDMA	Yes, simultaneous possible	Either
Gambling/screens/sugar	Yes, simultaneous possible	Either, anticipate transfers
Diverted medications	Depends on profile	Substitution if opioid, otherwise simultaneous

Why not postpone everything

Structures that help

The addiction-transfer trap

In United Kingdom

Your questions

If I quit everything at once, will I cave faster?

Not necessarily. Several studies show highly motivated people succeed better in simultaneous withdrawal than sequential. The risk mostly comes from lack of support, not the number of substances. With addiction-centre follow-up, often the most effective option.
My therapist says to keep tobacco 'not to overload'. Good advice?

Now contested. Recent recommendations (NICE, addiction specialists) encourage simultaneous quitting. If you feel ready, a specialist opinion can help.
And the e-cigarette in all this?

Vape can be a bridge to quit tobacco, especially if you combine tobacco + cannabis. Risk: staying dependent on nicotine long-term. Use as a step, not a final destination.
I use cocaine occasionally. Does it change my tobacco strategy?

Not drastically. Cocaine and tobacco are often socially associated, creating cross-triggers. Anticipate these situations during your quit.
I'm on Subutex (buprenorphine). Can I still take nicotine patches?

Yes, no interaction between buprenorphine and nicotine substitutes. Same for methadone. You can quit tobacco serenely alongside opioid substitution.
My circle discourages me: 'You're already quitting alcohol/cannabis, don't add tobacco.' What to do?

Your circle is likely well-meaning, but clinical experience shows that simultaneous quitting works well in motivated profiles. Discuss with an addictologist (addiction centre) for professional advice and structure your choice.

sources

NICE NG209 / CG115, Recommendations on managing addictive behaviours and tobacco dependence.
Schmitt A (CHU), Smoking cessation and co-addictions, training.
Deschenau A et al., Combined use of tobacco and cannabis, French Alcohology Society, 2024.
Ameli.fr, Addictions: who to contact? / Managing addictive disorders.
NHS Better Health, Withdrawal and co-addictions.
Action on Smoking and Health (ASH UK), Smoking and poly-substance use, data brief.