Inpatient treatment for tobacco dependence

Many smokers I’ve seen for help in quitting have made a comment like, “if only I could be isolated on a desert island for a couple of weeks without cigarettes, then I could quit.” Earlier this week a news item from my home country (Scotland) told of a 56 year-old successful businessman named Geoff Spice who had smoked for 43 years and then decided to live on a remote island by himself for a month to quit smoking. And this island is really remote…with no electricity and only sheep for companionship (?!). So do you think this is a god way to quit smoking?

Perhaps the closest thing to this here in the United States is the option of going to a specialist clinic for residential tobacco dependence treatment. A handful of these residential clinics exist, with the most famous being ones at Mayo Clinic and Hazelden Foundation (both in Minnesota) and the St Helena Center in California. These residential clinics typical have a 4 to 8 day program including classes, pharmacotherapy and multidisciplinary therapy. They are also typically quite expensive ($3000 to $6,000) for the patient (though not in comparison to the cost for inpatient treatment for lung cancer!).

These clinics typically boast high long term (6 month to a year) quit rates (25 to 65%). The Mayo Clinic published a comparison between one year quit rates in their inpatient and outpatient program, finding a higher quit rate after residential treatment (45% v 23%). Of course it is possible that those attending expensive inpatient treatment were more highly motivated (and more affluent) than the average smoker seeking treatment. However, it is plausible that the methods taught in the classes are helpful, and that there is an advantage of getting off to a good start by virtually guaranteeing abstinence for the first few days.

The main challenge for those who start their quit attempt at a residential clinic, or on an island, is staying quit once they return to their normal environment with all the same triggers and cues.

I’d be interested to hear of the experiences of anyone who has tried these or other “extreme” tobacco dependence treatments.

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About the Author

MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.