Residential Treatment Compared With Outpatient Treatment for Tobacco Use and Dependence

March 2011
Mayo Clinic Proceedings;Mar2011, Vol. 86 Issue 3, p203
Academic Journal
OBJECTIVE: To compare the effectiveness of outpatient vs residential treatment for tobacco dependence in a large referral practice. PATIENTS AND METHODS: We analyzed data from 2 cohorts of cigarette smokers who received either comprehensive outpatient or intensive 8-day residential treatment for tobacco dependence between January 1, 2004, and December 31, 2007. Self-reported 7-day point prevalence abstinence from smoking at 6 months was obtained via telephone interview. Logistic regression was used to assess the likelihood of increased abstinence with residential treatment. RESULTS: Overall, 4327 cigarette smokers received comprehensive outpatient treatment for tobacco dependence, and 226 smokers received treatment in an Intensive 8-day residential program. Compared with outpatients, residential patients smoked more cig. arettes per day (mean ± SD, 31.1±14.4 vs 21.2±11.2), had more severe nicotine dependence (Fagerstrom Test for Nicotine Dependence score, 6.9±2.0 vs 5.1±2.3), and were more likely to have been treated for alcoholism (58/222 [26%] vs 649/4327 [15%]) or depression (124/222 [56%) vs 1817/4327 (42%]; P<.001 for all comparisons). The 6-month smoking abstinence rate was significantly higher for residential patients compared with outpa. tients (115/222 [52%] vs 1168/4327 [27%]; unadjusted odds ratio, 3.0; 95% confidence interval, 2.3-3.9), with similar findings after adjusting for baseline characteristics (adjusted odds ratio, 3.58; 95% confidence Interval, 2.6-4.9). CONCLUSION: Compared with smokers who received outpatient treatment, those who received residential treatment had more severe tobacco dependence. Residential treatment for tobacco dependence was associated with a significantly greater odds of 6-month smoking abstinence compared with outpatient treatment among smokers in a referral clinic setting. Mayo Clin Proc. 2011;86(3):203-209


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