Smoking in treatment settings--the marketer's dilemma

Smoking is often called one of the most difficult addictions to overcome. Permitting the use of nicotine at treatment centers has been controversial—made even more so now by the proliferation of e-cigarettes. I have been particularly intrigued by treatment centers’ marketing around nicotine use.

For example, a prominent sober home for men in New England features clients smoking cigars on the front of its brochure. Executives at a residential setting in the Southwest I recently visited mentioned that they are lucky to be able to still offer designated smoking areas on campus—after all, marketing a tobacco-free campus to a prospective client can be a tough sell. A consumer-oriented magazine for people in recovery has an ad for an e-cigarette establishment on its back cover. Industry conferences have featured e-cigarette exhibitors, with seemingly enthusiastic attendee responses. In fact, one event actually offers a cigar-rolling sponsorship. On the other hand, a well-known New Jersey facility decided to publicize its decision to go smoke-free months before a state law required it to do so.

Nicotine use is generally frowned upon by society these days, with regulations restricting its advertising and most healthcare organizations adopting smoke-free campuses—and even zero-tolerance policies for employee tobacco use. Thus, it is surprising that as addiction treatment attempts to integrate into overall healthcare that marketers use smoking, overtly and subtly, to market their services. I’m no expert on whether smoking should be permitted in rehab settings, but one has to wonder how the public perceives treatment environments and affiliated field resources that permit smoking and even actively promote it.

Yet it is important to acknowledge that for a family in crisis looking to place a treatment-resistant loved one, a center permitting smoking may be desirable, given that nicotine seems to be the substance many are most reluctant to quit and, I suspect, an excuse for not going to treatment. If permitting smoking encourages more "hard-core" drug users to enter treatment, then one can argue that nicotine use, while not desirable, should be permissible.

I am not taking a position on one side or the other, as I can certainly understand the arguments for smoke-free campuses as well as empathize with the marketer who finds that a nonsmoking environment immediately turns off prospective clients who, many clinicians and marketers note, have "bigger" issues to tackle while in treatment. I suspect that overall societal headwinds will eventually snuff out smoking at all addiction settings, but in the meantime some facilities will find a competitive advantage to permitting smoking—and perhaps even promote this “benefit.” Whether there is value in promoting a smoke-free or smoke-friendly environment is certainly an interesting discussion that marketers should be having with clinical and executive staff, particularly as e-cigarette use becomes more pervasive.