COGNITIVE COPING AND DEPRESSION AMONG CIGARETTE SMOKERS

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DESCRIPTION: Improved methods of cigarette smoking cessation may result from increased understanding of the reasons for mixed results of prior attempts to target specific treatments to subgroups of smokers. This project addresses one such attempt, the incorporation of cognitive behavior therapy (CBT) for depression into smoking cessation programs for depression- history-positive smokers, who are otherwise at high risk for failure. Clinical trials of this strategy have yielded mixed findings. To illuminate the causes of these mixed findings, the proposed project will test two possible explanations for them: (a) depression vulnerability needs to be measured more directly, rather than inferred from a history of major depression, and (b) depression-vulnerable smokers are not in fact especially deficient in the mood management skills taught in cognitive behavior therapy, so that teaching these skills is unlikely to be a specifically useful treatment component for this subgroup of smokers. One hundred and sixty nondepressed adult smokers (80 with a history of major depression, 80 without) will participate in a cross-sectional comparison of general cognitive coping skills (as measured by the Ways of Responding test) and smoking-specific cognitive coping skills (as measured via articulated thoughts in smoking temptation situations). Besides history of depression, self-rated depression proneness will be used as a second marker of depression vulnerability to determine whether this distinction can account for inconsistent results in clinical trials of CBT. This research will provide critical data concerning (a) how best to measure depression vulnerability in future smoking cessation research and (b) whether the primary premise of efforts to match CBT to specific subgroups of smokers is accurate and therefore whether such matching efforts should be a high priority for additional clinical trials.