Inpatient treatment of severe nicotine dependence in a patient with thromboangiitis obliterans (Buerger's disease)

Thromboangiitis obliterans (TAO), or Buerger's disease, is an inflammatory, occlusive, and nonatherosclerotic vascular disease that most commonly affects small and medium-sized arteries and veins. The association between tobacco use and the development of TAO is incontestable; however, a substantial number of patients with TAO continue to use tobacco despite progression of disease and amputation. Herein we describe a patient with advanced TAO whose severe, refractory nicotine dependence was successfully treated in a specialized nicotine-dependence inpatient program. After cessation of smoking, the patient's disease stabilized. Inpatient nicotine- dependence treatment may represent an alternative for recidivist smokers with severe tobacco-related disease.