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Comparative Study
. 2011 Mar;86(3):203-9.
doi: 10.4065/mcp.2010.0703. Epub 2011 Feb 9.

Residential treatment compared with outpatient treatment for tobacco use and dependence

J Taylor Hays  1 , Ivana T Croghan, Darrell R Schroeder, Michael V Burke, Jon O Ebbert, David D McFadden, Richard D Hurt
Affiliations
Comparative Study

Residential treatment compared with outpatient treatment for tobacco use and dependence

J Taylor Hays et al. Mayo Clin Proc. 2011 Mar.

Abstract

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 cigarettes per day (mean ± SD, 31.1 ± 14.4 vs 21.2 ± 11.2), had more severe nicotine dependence (Fagerström 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 outpatients (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.

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Figures

FIGURE.
FIGURE.
Flow diagram of participant inclusion and exclusion criteria. NDC = Nicotine Dependence Center.
See this image and copyright information in PMC

Comment in

  • Underlying reasons for smoking.
    Cobb DK. Cobb DK. Mayo Clin Proc. 2011 May;86(5):469; author reply 469. doi: 10.4065/mcp.2011.0157. Mayo Clin Proc. 2011. PMID: 21531889 Free PMC article. No abstract available.

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