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The same 2015 study described nicotine as one of the most toxic of all poisons. The Pros and Cons of Smoking in Rehab From her experience working with patients who use cigarettes to cope in early recovery, Hernandez said, I cannot report any positive effects of smoking at any point based solely on a medical perspective. But, Hernandez has personally witnessed multiple downsides of smoking in treatment, starting with the continued attachment to a toxic or enabling relationship. She has seen firsthand how patients exhibit some of the same addictive behaviors theyre trying to kick, when asking for money for cigarettes and using smoking as an excuse to avoid groups or therapy sessions. The same dynamic (a continued attachment to a toxic or enabling relationship) may help to explain why some patients take up smoking in rehab