Introduction:
The prevalence of tobacco use is high in patients with other addictions. Morbidity and mortality associated with smoking are often higher than those produced by the “principal” drug. The Tobacco Detoxification-Mental Health Program (PDT-SM) is carried out in a smoke-free-inpatient detoxification unit of a general hospital. The intervention begins during hospitalization and continues for patients who wish maintain cessation after discharge. The purposes of the intervention are to increase awareness of tobacco risk, reinforce motivation for cessation and guarantee the continuity of smoking cessation in an outpatient setting.

Methods:
Population: smokers admitted for inpatient detoxification of other substance (October 2013-December 2017). At admission, data regarding smoking history and carbon monoxide (CO) in exhaled breath is obtained. Nicotine substitution is offered. During the hospitalization, weekly motivational group is carried out. Interested patients are referred to an outpatient specialized facility. They continue a free pharmacological and psychological treatment for one year.

Results:
166 patients were interested (14,5% of all smokers admitted), 66.3% men, mean age 46.5 years (SD 10). Patients with alcohol (46.4%) and cocaine (17.5%) addiction were the most interested. Depressive Disorder (18.1%) was the principal comorbidity. Average age of onset of tobacco use was 16 years old. 62% had prior quit attempts. Average number of cigarettes was 26.2 (SD 11.3), mean Fagerström test 6,9 (SD 2,1). 94% patients accepted nicotine substitution and assisted to group therapy. The level of CO decreased from an average of 19.3ppm (admission) to 1.8ppm (discharge).

Conclusions:
The results highlight that motivational interventions during admission in a detoxification unit could be effective to increase the awareness of tobacco risks, the self-efficacy of patients, and more important to promote quit-attempts in a very severe and resistant to treat patients.

Funding:
The Catalan Network of Smokefree Hospitals is partially funded by the Government of Catalonia through the Public Health Agency of Catalonia (contract SA-2017-N111).