There is a barrier to integrating smoking cessation services in substance abuse treatment for that very reason. We looked at national data from all of the substance abuse treatment facilities in the country and examined the prevalence of them offering smoking cessation services and found that it was lower than expected. Some clinicians misperceive that patients will become destabilized if they get rid of their nicotine and this will cause a relapse. Additionally, some of the staff members themselves smoke, so it can be difficult to tell clients not to smoke if they are also smoking.
The data show that if you treat tobacco or smoking and substance use at the same time, people have not only better tobacco outcomes, but better substance use outcomes. So there is good reason to treat them together.