Residential treatment for smokeless tobacco use: A case series

Ebbert, Jon O; Dale, Lowell C; Vickers, Kristin S; Gauvin, Thomas R; Bunge, Nadene E; Hurt, Richard D

doi:10.1016/j.jsat.2004.01.008

« Previous Next »Journal of Substance Abuse Treatment
Volume 26, Issue 4 , Pages 261-267, June 2004

Residential treatment for smokeless tobacco use: A case series

Jon O Ebbert, MD, MSc
- Corresponding author. Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. Tel.: +1-507-266-1944; fax: +1-507-266-7900
- Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
Lowell C Dale, MD
- Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
Kristin S Vickers, PhD
- Section of Patient Education, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
Thomas R Gauvin, MA
- Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
Nadene E Bunge, MA
- Department of Dental Specialties, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA
Richard D Hurt, MD
- Nicotine Dependence Center, Mayo Clinic, 200 First Street, SW, Rochester, MN, USA

Received 6 September 2003; received in revised form 6 January 2004; accepted 27 January 2004.

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.

Keywords: Residential treatment, Smokeless tobacco, Bupropion, Tobacco use cessation, Behavioral therapy