MOOD MANAGEMENT TRAINING FOR ALCOHOL DEPENDENT SMOKERS

此应用程序将作为PI将在其上构建的基础 致力于酒精和尼古丁领域的主要研究方向 依赖治疗。酒精依赖吸烟者患酒精性心脏病的风险高 与烟草有关的发病率和死亡率。有效的干预措施是 需要降低这一人群中的吸烟率。在吸烟者中， 严重抑郁症的病史被认为是主要障碍。 为戒烟干杯。有酒精依赖史的个人 而严重的抑郁症可能代表着一个特别接受治疗的人群- 抗拒吸烟者。这项新的调查员提案建立在我们的 以前的工作，重点是治疗有这两种病史的吸烟者 酒精依赖和严重的抑郁症。的理论框架。 这个研究项目的基础是社会学习 复吸的认知-行为模型，强调了 成瘾复发中的情境变量和应对反应。我们的 初步工作表明，一种情绪管理干预，设计 加强应对负面情绪，可能会改善吸烟的结果 有酒精依赖和抑郁症病史的吸烟者。第一 这项研究的主要目的是评估情绪的有效性。 144名成年人12个月吸烟后果的管理干预 有严重抑郁症病史的戒酒吸烟者。一个 进一步的目标是审查相关的变革机制和进程 与吸烟治疗结果有关。第二个主要目标是检查 吸烟治疗对戒酒和戒酒的影响 确定与吸烟和饮酒结果相关的因素。这个 这项工作的最终目标是开发有效的干预措施， 将减少与烟草相关的发病率和死亡率在这一高风险 在不对饮酒结果产生不利影响的情况下对人口进行干预。一个随机的， 两组设计将被用来评估情绪的额外好处 管理干预与最先进的戒烟方法的比较 治疗。这两个条件是：1)尼古丁透皮疗法和 行为咨询(BC)和2)BC+认知-行为情绪 管理培训(MM)。治疗将由8周一组组成 会话。主要评估将在治疗结束(周)进行 8)，以及1、3、6和12个月的随访。依赖措施包括7天 用过期空气碳证实吸烟戒烟的时点流行 一氧化碳、酒精和毒品的戒断通过酒精测试仪进行了验证， 尿液药物筛查和举报人报告。

This application will serve as the foundation on which the PI will build a major line of research dedicated to the area of alcohol and nicotine dependence treatment. Alcohol dependent smokers are at high risk for tobacco-related morbidity and mortality. Effective interventions are needed to reduce smoking prevalence in this population. Among smokers, a history of major depression has been identified as a major obstacle to smoking cessation. Individuals with a history of alcohol dependence and major depression may represent a population of especially treatment- resistant smokers. This new investigator proposal builds on our previous work and focuses on treatment of smokers with a history of both alcohol dependence and major depression. The theoretical framework on which this program of research is based is the social learning cognitive-behavioral model of relapse which emphasizes the role of situational variables and coping responses in addiction relapse. Our preliminary work suggests that a mood management intervention, designed to enhance coping with negative affect, may improve smoking outcomes for smokers with a history of alcohol dependence and depression. The first primary aim of this study is to evaluate the efficacy of a mood management intervention on 12-month smoking outcomes for 144 adult, abstinent alcoholic smokers with a history of major depression. A further aim is to examine mechanisms and processes of change associated with smoking treatment outcomes. The second primary aim is to examine the effect of the smoking treatments on alcohol abstinence and to identify factors associated with smoking and alcohol outcomes. The ultimate goal of this work is to develop effective interventions which will reduce tobacco-related morbidity and mortality in this high-risk population without adversely affecting alcohol outcomes. A randomized, two-group design will be used to evaluate the added benefit of a mood management intervention compared to a state-of-the-art smoking cessation treatment. The two conditions are: 1) Transdermal Nicotine Therapy and Behavioral Counseling (BC) and 2)BC plus Cognitive-Behavioral Mood Management Training (MM). Treatment will consist of 8 weekly group sessions. The major assessments will occur at end-of-treatment (week 8), and 1,3,6,and 12-month follow-up. Dependent measures include 7-day point prevalence smoking abstinence verified with expired air carbon monoxide and alcohol and drug abstinence verified with breathalyzer, urine drug screen and informant report.