Abstract
OBJECTIVE: To evaluate a pilot 4-day residential smoking treatment program for smokers who had relapsed after participation in an outpatient smoking program.
DESIGN: A single-arm clinical trial. Participants stayed in a supportive, smoke-free environment for 4 days during which they attended educational sessions on nutrition, exercise, and psychology. Nicotine withdrawal was treated with nicotine inhalers and patches. After discharge, participants attended monthly outpatient group sessions for 6 months.
SETTING: The Durham, NC Veterans Affairs Medical Center residential unit.
PARTICIPANTS: Twenty-three medical outpatient smokers.
MEASUREMENTS: Seven-day point prevalence smoking abstinence was determined by self-report of zero cigarettes smoked and verified by exhaled carbon monoxide <8 parts per million.
MAIN RESULTS: Participants’ mean age was 57.4 years; 100% were male; 61% were Caucasian; and 39% were African American. The mean score on the Fagerström Test for Nicotine Dependence was 7.1 (SD 2.3). Daily nicotine doses ranged from the nicotine inhaler alone to 56 mg of transdermal nicotine plus nicotine inhaler. Verified smoking abstinence on discharge (after 4 days) was 21/23 or 91.3% (95% confidence interval [95% CI], 73 to 100). At 6 months, the 7-day point abstinence rate was 6/23 or 26.1% (95% CI, 15 to 36).
CONCLUSIONS: This pilot residential smoking treatment program was designed to assist smokers who relapsed after outpatient treatment. Four days of residential smoking therapy successfully relieved smoking withdrawal. At 6 months after discharge, participants maintained an abstinence rate comparable to other medical therapies for smoking.
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References
Allen A. Smoking-related disease in a VA hospital. Prev Med. 1988;17:440–8.
Dawley H Jr., Butler B. An 8-year comparison of hospitalized veterans’ attitudes toward smoking and smoking cessation. Int J Addict. 1987;22:785–90.
LaCroix AZ, Omenn GS. Older adults and smoking. Clin Geriatr Med. 1992;8:69–87.
Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2002;3:CD001007.
Richmond RL, Kehoe L, de Almeida Neto AC. Effectiveness of a 24-hour transdermal nicotine patch in conjunction with a cognitive behavioural programme: one year outcome. Addiction. 1997;92:27–31.
Silagy C, Mant D, Fowler G, Lancaster T. Nicotine replacement therapy for smoking cessation. Tobacco Addiction Module. Cochrane Database Syst Rev. 2001;3:CD000146.
Heishman SJ, Henningfield JE, Kendler KS, et al. Society for Research on Nicotine and Tobacco. Third Annual Scientific Conference, Nashville, Tennessee, USA, 13–14 June 1997. Addiction. 1998;93:907–23.
Rigotti NA, Arnsten JH, McKool KM, Wood-Reid KM, Pasternak RC, Singer DE. Efficacy of a smoking cessation program for hospital patients. Arch Intern Med. 1997;157:2653–60.
Simon JA, Solkowitz SM, Carmody TP, Browner WS. Smoking cessation after surgery. A randomized trial. Arch Intern Med. 1997;157:1371–6.
Westman EC, Behm FM, Simel DL, Rose JE. Smoking behavior on the first day of a quit attempt predicts long-term abstinence. Arch Intern Med. 1997;157:335–40.
The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. A clinical practice guideline for treating tobacco use and dependence: a US Public Health Service report. JAMA. 2000;283:3244–54.
Orleans CT. Treating nicotine dependence in medical settings: a stepped-care model. In: Orleans CT, Slade J, eds. Nicotine Addiction: Principles and Management. New York: Oxford University Press; 1993:145–61.
Shipley RH, Rose J. QuitSmart: stop smoking. Durham, NC: QuitSmart Stop Smoking Resources; 1997.
Hurt R, Lowell D, Offord K, Bruce BK, McClain FL, Eberman KM. Inpatient treatment of severe nicotine dependence. Mayo Clin Proc. 1992;67:823–8.
Pomerleau CS, Carton SM, Lutzke ML, Flessland KA, Pomerleau OF. Reliability of the Fagerström tolerance questionnaire and the Fagerström test for nicotine dependence. Addict Behav. 1994;19:33–9.
Shiffman S, Jarvik ME. Smoking withdrawal symptoms in 2 weeks of abstinence. Psychopharmacology (Berl). 1976;50:35–9.
Westman EC, Rose JE. Do heavy smokers need a higher replacement dose of nicotine to quit? JAMA. 1996;275:1882–3.
Javis MJ, Russell MAH. Expired air carbon monoxide: a simple breath test of tobacco smoke intake. BMJ. 1980;281:484–5.
Jarvis MJ, Tunstall-Pedoe J, Feyerabend C, Vesey C, Saloojee Y. Comparison of tests used to distinguish smokers from nonsmokers. Am J Public Health. 1987;77:1435–8.
Patrick D, Cheadle A, Thompson D, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994;84:1086–93.
Bohadana AB, Nilsson F, Rasmussen T, Martinet Y. Nicotine inhaler and nicotine patch as a combination therapy for smoking cessation. A randomized, double-blind, placebo-controlled trial. Arch Intern Med. 2000;160:3128–34.
Hays JT, Wolter TD, Eberman KM, Croghan IT, Offord KP, Hurt RD. Residential (inpatient) treatment compared with outpatient treatment for nicotine dependence. Mayo Clin Proc. 2001;76:124–33.
An Ounce of Prevention. What Are the Returns? 2nd ed. Atlanta, Ga: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Prevention Effectiveness Branch, Division of Prevention Research and Analytic Methods, Epidemiology Program Office; 1999.
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Green, A., Yancy, W.S., Braxton, L. et al. Residential smoking therapy. J GEN INTERN MED 18, 275–280 (2003). https://doi.org/10.1046/j.1525-1497.2003.11114.x
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DOI: https://doi.org/10.1046/j.1525-1497.2003.11114.x