Smoking Cessation Intervention for Depressed Smokers: Treatment Development

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DESCRIPTION (provided by applicant): The development of effective smoking cessation treatments for smokers with current depression may have important clinical and public health significance in reducing the overall morbidity and mortality associated with smoking. A disproportionate number of Americans who die each year from smoking-related causes have a lifetime history of major depressive disorder, and depression is strongly associated with increased medical morbidity and mortality. It seems likely that smokers with co-occurring depression may be among those at greatest risk for developing smoking-related medical disorders. Because smoking cessation treatment studies have traditionally excluded smokers with current major depressive disorder (MOD), very little is known regarding the impact of more severe depressive symptoms on smoking cessation outcome. However, there is a good deal of data showing that subsyndromal levels of depressive symptoms are predictive of smoking cessation failure. Depressive symptoms in smokers with current depressive disorders may pose even greater obstacles to abstinence. These individuals may require additional treatment that targets their depressive symptoms before they will be successful in achieving abstinence. The goal of this study is to provide a preliminary test of the effect of cognitive behavioral analysis system of psychotherapy (CBASP), an existing treatment that has been found to be efficacious in the treatment of chronic depression, in combination with standard smoking cessation treatment (CBASP/ST), on both short and long-term point prevalence abstinence in smokers with current MOD. Sixty smokers with current MOD will be recruited and randomly assigned to either the CBASP/ST treatment or standard smoking cessation treatment alone (ST). The nicotine patch will be included as part of standard treatment in both conditions. Based on the outcome of this preliminary trial, the CBASP/ST treatment protocol will be further refined and readied for larger-scale clinical trials.