Residential (inpatient) treatment compared with outpatient treatment for nicotine dependence

Objective: To compare smoking abstinence outcomes between smokers treated i n a residential (inpatient) program and those treated in an outpatient prog ram to determine if residential treatment was superior to outpatient treatm ent in smokers with moderate to severe nicotine dependence. Patients and Methods: Patients treated in the residential nicotine dependen ce program at the Mayo Clinic, Rochester, Minn, between May 1, 1992, and Ja nuary 31, 1996, were selected for this study, Each patient in the residenti al treatment group (n=146) was matched to 2 patients who received an outpat ient nicotine dependence consultation by a trained counselor (n=292), Each patient was matched on age, sex, year seen, number of cigarettes smoked per day, longest previous abstinence, education, and marital status, Abstinenc e at 6 and 12 months was determined by self-report. For the purposes of ana lysis, each patient with missing outcome data was considered to be smoking. Results: The 6-month abstinence rates for the residential group compared wi th the outpatient group were 45% and 26%, respectively (P<.001), and the 12 -month abstinence rates were 45% and 23%, respectively (P<.001). After adju sting for matching variables that were not exactly matched (age, baseline n umber of cigarettes smoked per day, and longest previous abstinence) and th e baseline variables, including education, age when started smoking, and de gree of nicotine dependence, there was a significant effect of residential treatment on 6- and 12-month abstinence rates (P < .001). Odds ratio of 6-m onth abstinence In the residential group was 2.74 (95% confidence interval, 1.60-4.71; P<.001) and at 12 months was 3.03 (95% confidence interval, 1.7 4-5.27; P<.001). Conclusion: Residential treatment for tobacco dependence is superior to out patient treatment in some smokers who are moderately to severely nicotine d ependent.