SMOKING TREATMENT FOR ALCOHOL ABUSING ADOLESCENTS

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APPLICANT'S ABSTRACT: Cigarette smoking is a leading cause of morbidity and mortality and is the leading preventable cause of lung and other cancers. It results in substantial health care expenditures. Despite extensive efforts at preventing smoking, youth continue to initiate and maintain smoking at significant levels. Research shows that adolescent use of cigarettes and alcohol increases concurrently. Teens treated for alcohol and other drug abuse evidence substantial and persistent cigarette involvement that identifies this group as a particularly important target for smoking cessation intervention. Adolescent smoking cessation treatment research is in its infancy, with limited knowledge to inform the development of interventions. To address this issue, the goal of this proposed exploratory/developmental (R21) project is to develop an intervention designed specifically for alcohol-abusing adolescent smoking cessation. Information from this study will provide a better understanding of factors associated with alcohol-abusing teen smoking cessation and will produce an initial intervention that will serve as the basis for future treatment outcome research. The study design draws on theoretical and empirical contributions of the biobehavioral model of addiction (e.g., Donovan, 1988). Existing data on correlates of teen smoking cessation, and adult and alcohol abuser smoking cessation guide the design of the intervention development. The intervention consists of 2 phases, smoking reduction and cessation/relapse prevention, to be delivered in a group format to 84 adolescent alcohol abusers. Successive versions of the intervention will be modified based on participant and group leader feedback. The primary hypotheses of this study are a) that participant teens will evidence significantly reduced rates of cigarette smoking, and b) that pretreatment nicotine dependence will predict post-treatment smoking.