title: Residential treatment for smokeless tobacco use: a case series.
abstract: We developed and implemented a novel 8-day residential treatment program for smokeless tobacco (ST) use. A multidisciplinary team delivered behavioral treatment, nicotine patches were adjusted to achieve 100% replacement of baseline peak serum nicotine concentrations, and bupropion sustained-release was prescribed. Mean participant age (+/- SD) was 47.4 +/- 18.2 years. Mean nicotine patch dose at program end was 43.2 mg/day +/- 13.9 (range 14 to 66 mg/d). Median percent replacement by serum nicotine concentrations was 86.6% (IQR: 75-113.8%). At 1 year, the biochemically-confirmed (urine anabasine <2.0 ng/mL) self-reported 7-day point prevalence tobacco abstinence rate was 58% (14/24). A residential treatment program for ST users may be effective. More research is needed to replicate our findings and determine if comparable abstinence rates can be achieved with outpatient ST treatment programs using similar behavioral and pharmacotherapies.
authors.affiliation: Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. ebbert.jon@mayo.edu
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.forename: Lowell C
authors.initials: LC
authors.lastname: Dale
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Vickers
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Gauvin
authors.forename: Nadene E
authors.initials: NE
authors.lastname: Bunge
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
mesh_terms: D000279:Administration, Cutaneous; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001521:Behavior Therapy; D016642:Bupropion / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage; D018722:Nicotinic Agonists / Q000008:administration & dosage; D010865:Pilot Projects; D012114:Residential Treatment; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D014030:Tobacco, Smokeless
chemical_list: D018687:Antidepressive Agents, Second-Generation; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine