Kotz M M
Cleveland Clinic Foundation, OH 44195.
J Subst Abuse Treat. 1993 Mar-Apr;10(2):125-31. doi: 10.1016/0740-5472(93)90036-2.
An attempt to eliminate smoking from the CCF chemical dependency unit resulted from an institutional mandate that the campus be smoke-free. Initially, patients were given the option of either not smoking or smoking outside with staff supervision. Those who opted for smoking cessation received no specific treatment for nicotine addiction, but were only given snacks, therapeutic activities, and stress management techniques to aid in their effort. The initiative failed. Patient and staff resistance, hazardous conditions due to surreptitious smoking, and interference with other treatment components led to suspension of the policy. A second attempt, thought to be a superior design, included therapeutic interventions similar to traditional addiction treatment; however, it also failed to produce nicotine recovery in most patients. It was noted that patients with such adverse consequences from nicotine as emphysema or cancer could be motivated to recover from nicotine addiction and were helpful in motivating those without consequences to stop smoking. Significantly, despite several patients' refusal to enter or continue in treatment due to the no smoking policy, unit census actually increased.
因学校规定校园内禁止吸烟，所以曾尝试在CCF化学成瘾治疗科禁烟。起初，患者可以选择不吸烟，或者在工作人员监督下到室外吸烟。选择戒烟的患者未接受针对尼古丁成瘾的特定治疗，只是提供了零食、治疗活动以及压力管理技巧来帮助他们。这项举措失败了。患者和工作人员的抵制、偷偷吸烟导致的危险状况以及对其他治疗环节的干扰，致使该政策暂停。第二次尝试被认为是更好的设计，包括了与传统成瘾治疗类似的治疗干预措施；然而，大多数患者仍未能成功戒除尼古丁。据指出，患有诸如肺气肿或癌症等尼古丁所致不良后果的患者，可能会有动力戒除尼古丁成瘾，而且有助于激励没有这些后果的患者戒烟。值得注意的是，尽管有几名患者因禁烟政策拒绝接受治疗或继续治疗，但科室的患者人数实际上却增加了。
