title: Residential treatment compared with outpatient treatment for tobacco use and dependence.
abstract: OBJECTIVE
  To compare the effectiveness of outpatient vs residential treatment for tobacco dependence in a large referral practice.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nicotine Dependence Center, Mayo Clinic, Rochester, MN 55905, USA. hays.taylor@mayo.edu
authors.forename: J Taylor
authors.initials: JT
authors.lastname: Hays
authors.forename: Ivana T
authors.initials: IT
authors.lastname: Croghan
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Michael V
authors.initials: MV
authors.lastname: Burke
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.forename: David D
authors.initials: DD
authors.lastname: McFadden
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012114:Residential Treatment; D016540:Smoking Cessation; D016320:Substance Abuse Treatment Centers; D014029:Tobacco Use Disorder / Q000517:prevention & control* / Q000523:psychology; D016896:Treatment Outcome