Abstract
Tobacco use remains a major public health concern worldwide. In residential treatment facilities for substance use disorders, little effort is made to help individuals quit smoking, even though the primary goal of treatment is to promote the overall health through abstinence from all drugs. The aim of this study was to analyze the perceptions of professionals and individuals in treatment regarding the management of tobacco use within residential therapeutic settings. We conducted a qualitative study in treatment centers in Spain, using thematic content analysis of focus groups with 29 professionals and 53 individuals. According to participants, tobacco use during substance use disorder treatment substitutes for the use of other drugs and serves as a tool for emotional regulation. Furthermore, many participants believed that quitting smoking may increase the risk of relapse for other substances, although scientific evidence shows otherwise. These insights suggest that prevailing attitudes toward tobacco use in treatment contexts are outdated, underscoring the need for a paradigm shift in how this issue is addressed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).