Nicotine addiction is still classified as a lifestyle instead of a disease in Germany, although recently established non smoking policies have shown remarkable effects on population's health and economic profits for health insurances. Scientific community is requesting more intensive cessation programs especially for certain patient groups such as lung cancer or copd affected persons. Mentally retarded have rarely been examined in terms of health risks or been in the focus of health promotion programs.

In January 2012 we conducetd a pilotproject with three mentally retarded COPD patients (2 male, 1 female). A flat next to the hospital grounds was rented for one week and patients were enrolled in daily cognitive behavioural, medical and sports programs. Meals were consumed at the hospital cafeteria and leisure time acitivities were planned by regular counsellors and mobile nursing services. Booster sessions were held twice monthly at their assisted living homes. One male patient was successful all at once; while other two accomplished smokefree day time periods supported by NRT. During first six months of aftercare several attempts were taken leading to a three week lasting smoke free period for the second male patient. Female patient did not have any further motivation to quit. However improvements in medical condition and quality of life were observed.

Intensified therapy might be a reasonable option for “complicated” patients.