Initial encounters with tobacco cessation on the Inpatient Substance Abuse Unit of the Medical College of Virginia.

When the Medical College of Virginia became a smoke-free facility on May 1, 1990, the inpatient unit of the Division of Substance Abuse Medicine decided that it would require tobacco abstinence of its patients, and that it would treat nicotine addiction in a similar fashion as other chemical dependencies. Surreptitious alcohol and drug use on the unit was minimal, but clandestine cigarette smoking prevailed. The succeeding restrictive environment and enforcement efforts became counterproductive. Beginning December 23, 1990, the inpatient unit decided to re-allow smoking. A motivational curriculum for all patients and an optional cessation program for those patients who wish to quit smoking during their inpatient stay is planned. Methods to effectively address nicotine addiction during chemical dependency treatment need to continually be refined and explored.