Nicotine dependence is a world health problem. The objective of this paper is to present the implementation of a treatment program and the use of varenicline as a specific medication for nicotine dependence during internment at our clinic in Rio de Janeiro.

The program starts with a first evaluation done by a psychiatrist. The initial dose of varenicline is 0,5 mg on the first 3 days raising to 0,5 mg twice a day from day 4 to day 7; after that it is increased to 1mg twice a day until 12 weeks are completed. It is suggested that the patient picks up a day to quit smoking, between the first and second week of use. It was also given behavioral and focal group therapy. During 14 months, we established a continuous reduction on the number of cigarettes, from 20 to 1 and finally 4 a day.

There were 354 patients attending the program from June 2008 to August 2009 and 69 (19,5%) accepted the whole program. From them, 56 (81,2%) used varenicline and all of them reached abstinence. Also, we followed these 56 patients for the last 6 months and 38 (67,8%) were still abstinent.

There was a high number of acceptance as well as of abstinence. Group and behavioral therapies can be important allies to varenicline. It is important to remember that the high cost of this medication remains an impediment for wide use. A planned reduction with cultural changes can also be very effective.