Being locked up to quit smoking


11:14 PM - Jan 29, 2003#1

I originally wrote this to a member asking if we knew of a program that would lock her up so she would have to quit smoking:

I do think there are some clinics out there that do basically lock up people to quit smoking. But I wouldn't put much stock in the technique. We lock up people all the time in our hospital and don't let people smoke. It's not in our smoking clinic; it's in our intensive care unit. You can lock people up for days and weeks if the condition is serious enough.
Technically, these people are detoxed from nicotine. Heck, some of them were comatose and never even experienced withdrawal. In theory, this sounds appealing to some smokers. But the reality of the situation is often, in fact maybe more often than not; the first thing these patients do upon release from the hospital is grab for a cigarette. You see these people never quit smoking. They were smokers who were just not allowed to smoke.

They don't learn anything about survival in the real world without smoking. They know how to be fed intravenously, they know how to use a remote on a television, but that is about it. The urge for a cigarette upon being released is incredible. It's interesting though, there is a real easy way to stop the urge. Throw them on a gurney, stick an IV in their arm and all of a sudden they don't need a cigarette. They are doing the one thing they learned, being a connected patient.

People need to face the real world as quickly as they can to start to break the associations of day to day rituals. Only then will they prove to themselves that there is life after smoking.

As far as being sad, this is normally experienced when quitting. Unlike the physical symptoms, striking hard and then dissipating within days, psychological symptoms are less predictable. But in some ways, they are also more controllable. I am going to attach to letters here to this post addressing these issues. They have been on the board recently, but so you don't have to scramble looking for them they will be right here.

Hope this helps a little.


P.S. There actually was a hospital in the Chicago area that used to have an inpatient unit for smoking cessation. It went under in less than a year of operation. I had three of their patient's come to my program to quit. Two of them made it. All of them said that they were basically doped up during the hospitalization. I think they were using a drug called clonidine at the time. Powerful antihypertensive that at one time was thought to be helpful. Never met anyone who actually got off smoking using it though. So if you find a program, check out what they do before assuming it's a good plan.

Emotional Loss Experienced from Quitting Smoking
Normal depressive reaction or a real organic depressive episode
Last edited by Joel on 5:30 PM - Apr 06, 2011, edited 2 times in total.


11:48 PM - Apr 29, 2003#2

I saw a program on T.V the other night about a doctor who has a program where he
puts heroin addicts to sleep so they don't go through withdrawls. He keeps them medicated so they don't get any symptoms. And guess what? He was perplexed as to why he only had a 2% sucsess rate. The patients would go right back out and not change a behavior but expect to be "healed". Sad, but your right on. You have to expierance life free of your addiction before you can face it. Life that is.
Eleven months, three weeks, four days, 4 hours, 28 minutes and 48 seconds. 28814 cigarettes not smoked, saving $4,308.32. Life saved: 14 weeks, 2 days, 1 hour, 10 minutes.

Gr8fulGirl Silver

6:48 AM - Jun 15, 2003#3

If ever before, and even stronger right here right now, I can see how staying successful is all about CHOICE! Thank you Joel!

1 month 6 days quit!

BubblyDoodlebug Gold

11:00 PM - Jun 15, 2003#4

This post has helped me understand something my dad did. My father had a heartattack the day before this past Thanksgiving. He was in ICU for a little over six weeks and spent a few weeks in a Nursing Home. During this whole time he was smoke free. I talked to him a few times on the phone and he was so excited about not smoking and about two hours after he left the Nursing Home he bummed a cig. Even though I was smoking at the time I was furious at him. Now I'm just sad for him. Katherine 1 month 3 days


10:16 PM - Jan 02, 2004#5

For people who may have been shutting themselves in for the beginning of 2004 in order to quit smoking. Freedom from Tobacco does not mean becoming a prisoner of quitting but rather means to understand that by quitting you are freeing yourself up to really experience a healthier, happier and likely a longer life simply by sticking to the commitment you made when you joined up to never take another puff! Joel


8:28 PM - Aug 22, 2004#6

Some of our members may actually find themselves dealing with people who are "locked up" and currently prevented from smoking. Our members who are hospital workers often find themselves in the position of encountering smokers who are being restricted from smoking. The restriction that a hospital can impose can only prevent smoking in the present. You may very well be able to help to effect a more permanent resolution to these patients' smoking problem. Not by force but by passing along some simple information and insights. To really help your patients it is crucial to help them to understand that smoking is a true form of drug addiction. If they can come to understand this they will have a powerful first step in quitting. The second thing to get across to them is that while smoking is a drug addiction, it is fully within their cabability to quit and to stay smoke free over a lifetime. Our members are all uniquely qualified to pass along this understanding for they have all proven beyond a shadow or a doubt that they have quit and they have continued to stay successfully smoke free by simply making the commitment and then sticking the commitment to never take another puff!



1:25 AM - Oct 05, 2004#7

I saw a post from a member who basically took off of working and thinking the couple of weeks in order to make a smoother transition into not smoking. Unfortunately, avoiding the real world is not the way to really learn how to function in that world without smoking. The following comment lifted from the day after new years post covers this issue:
From: Joel Sent: 1/2/2004 8:16 AM
For people who may have been shutting themselves in for the beginning of 2004 in order to quit smoking. Freedom from Tobacco does not mean becoming a prisoner of quitting but rather means to understand that by quitting you are freeing yourself up to really experience a healthier, happier and likely a longer life simply by sticking to the commitment you made when you joined up to never take another puff! Joel


11:45 PM - Jan 17, 2005#8

No one needs to be locked up or avoid day to day rituals in order to sustain his or her quit. Everything you did as a smoker you can still do as an ex-smoker. The way to continue to prove this premise to yourself is to go on facing your day to day life while continuing to stick to your commitment to never take another puff!



8:58 PM - Jan 26, 2005#9

Recommend Delete Message 59 of 75 in Discussion
From: John (Gold) Sent: 3/2/2004 12:33 PM
For Smoker,
More Prison Time Is No Crime
Tues. March 2, 204
WINNIPEG, Manitoba (Reuters) - For a 73-year-old Canadian man, 20 months in a smoke-free jail looked just too long, so instead he took 24 months in a prison where he can smoke cigarettes.[/size]

Angelo Foti was sentenced to 20 months for shooting and wounding a man in his backyard who was trying to repossess a snowmobile sold to Foti's son, the Winnipeg Free Press reported Tuesday.

In court Monday, Angelo Foti was agitated when he realized the sentence would mean he would be in a provincial jail, where smoking is banned, the newspaper said.

Foti's lawyer pleaded for a 24-month sentence instead, which means the man will go to a federal prison, where smoking is allowed.

In accepting the longer term, Foti, a dedicated pack-a-day man, ignored the wishes of this family.

"Dad, they're just cigarettes -- give them up. Quit smoking: you'll be healthier," his son Angelo Jr. said in court. "Just take the 20 months."
Link to story:
Copyright © 2004 Reuters Limited. All rights reserved
Thanks Jill for the story link!
Last edited by Joel on 11:29 AM - Apr 12, 2009, edited 1 time in total.


6:57 PM - Oct 26, 2006#10

I have been working under the false perception that most cardiac patients have been being locked up and basically detoxed from nicotine in hospitals over the past ten years since smoking was not allowed in hospitals and as far as I knew most doctors wouldn't put a patient hospitalized with cardiac problems on nicotine replacement. I know when I worked in hospitals this practice did not happen. Apparently things have changed though, as is evident by this article:
Nicotine patches may
boost intensive care risk
  • 19:30 25 October 2006
  • news service
  • Roxanne Khamsi
Nicotine given to intensive care patients to ease their withdrawal from cigarettes may put them at a greater risk of death than going "cold turkey", researchers say.

A preliminary study of more than 200 smokers placed in intensive care suggests they are better off simply enduring withdrawal symptoms than receiving nicotine replacement therapy (NRT).

Nicotine replacement therapy has become common in hospitals' intensive care units (ICUs) in the last five to 10 years. The drug reduces withdrawal symptoms, such as headache and irritability, among smokers in these units, who are too sick to go to an area where they can smoke.

Bekele Afessa at the Mayo Clinic College of Medicine in Rochester, Minnesota, US, and colleagues expected to find that patients comforted by (NRT) fare better than smokers who do not receive it.

Heart power The team examined the intensive care records of 224 smokers, half of which received NRT, mostly via skin patches.

Surprisingly, they found that 18 of the patients on NRT died, compared with just three of the smokers that did not receive nicotine. Also, the average duration of an ICU stay for patients given nicotine was 24.4 hours, about 2 hours longer than their cold-turkey counterparts.

"We have to be aware that we may be doing some harm [by giving patients NRT]," Afessa warns.

He notes that many of the patients in the study had been admitted to the ICU because they had gone into sepsis due to an infection. Sepsis can cause the body to release myocardial depressant factor, a molecule that reduces the pumping power of the heart.

Nicotine may further weaken the hearts of these patients by causing the coronary artery feeding the heart, to narrow, he suggests. This would reduce the amount of oxygen being pumped to other organs in the body. Many of the ICU patients in the trial died of multiple organ failure.

Wake-up call Nicotine is known to cause a narrowing of the coronary artery in chronic smokers, but remains unknown whether short-term doses of the drug can have the same effect.

Experts say the results of the new study should encourage more research on how NRT affects hospital patients. "This is a wake-up call that we really need to study this," says Mark Rosen, president of the American College of Chest Physicians.

He adds, however, that a large prospective study is necessary to establish whether nicotine definitely causes an increased risk of death among patients.

Afessa presented the findings at the annual meeting of the American College of Chest Physicians (ACCP) in Salt Lake City, Utah, US, on Wednesday.
© Copyright Reed Business Information Ltd.
Source Link: ... -risk.html


John (Gold)

3:25 AM - Jul 20, 2007#11

Joel has been helping me prepare to present effective cessation seminars to prisoners in institutions that are going tobacco-free and this thread was part of my assigned reading. Yes, even after seven and a half years of studying under him he keeps drilling us with lessons ; )
Anyway, today I called the most renouned inpatient smoking cessation program in the U.S. to ask their rate and was told that their 7 day stay was $5,000. I'm hoping to get a small chuckle by pointing out that folks are paying big bucks to get locked up so they can quit smoking when they're getting it for free. In all seriousness, it's a challenging population as about one-third of inmates at my first stop are either in for life or on death row and what motived many here to quit may not be as important to them.
I did stumble upon an interesting fact that I'm still finding hard to digest. It demonstrates how stopping and quitting are two different things when looking a prisons compelling cessation by banning tobacco and or nicotine products. It's the fact that in at least one study, 97% of inmates released from a prison that had banned smoking had relapsed to smoking within 6 months of release.
Source: ... nck#123155, citing: Tuthill RW, Lincoln T, Conklin TJ, Kennedy S, Hammett TM, Roberts CA. "Does involuntary cigarette smoking abstinence among inmates during correctional incarceration result in continued abstinence post release?" (poster). 26th National Conference on Correctional Health Care, Nashville, Tennessee, October 21, 2002.[/size]
But that 97% relapse rate leaves a mountain of room for improvement and I'm convinced what we teach here can have a significant impact upon those living in a state of double captivity. Still just one rule for each of us .... no nicotine today!
John (Gold x8)
Last edited by John (Gold) on 11:33 AM - Apr 12, 2009, edited 1 time in total.

12:44 AM - Mar 04, 2011#12

Last edited by Joel Spitzer on 3:55 AM - Mar 04, 2011, edited 1 time in total.