BACKGROUND: Prevalence of smoking among individuals with posttraumatic stress disorder (PTSD) is disproportionately high, and PTSD is associated with especially poor response to smoking cessation treatment. OBJECTIVE: The current study examined whether integrating treatments for smoking cessation (varenicline plus smoking cessation counseling; VARCC) and PTSD (prolonged exposure therapy; PE) enhances smoking outcomes among smokers diagnosed with PTSD. METHOD:142 adults with nicotine dependence (ND) and PTSD were randomized to a treatment program consisting of varenicline, smoking cessation counseling, and PE (VARCC + PE) or to VARCC only. Seven-day point prevalence abstinence (PPA) at posttreatment (3-months postquit day) and follow-up (6-months postquit day), verified by serum cotinine levels and exhaled carbon monoxide, was the primary smoking outcome. Psychological outcomes were PTSD and depression severity. Mixed effects models included baseline PTSD severity as a moderator of treatment condition effects. RESULTS: Overall, VARCC + PE participants did not show greater PPA than VARCC participants. However, treatment effects were moderated by baseline PTSD severity. For participants with moderate and high PTSD severity, VARCC + PE led to significantly higher PPA than VARCC alone (ps<.05). No differences between treatment conditions emerged for participants with low baseline PTSD severity. Participants who received PE showed significantly greater reduction of PTSD and depression symptoms than those who did not receive PE. CONCLUSIONS: Integrating psychological treatment for PTSD and smoking cessation treatment enhances smoking cessation for participants with moderate or severe PTSD symptom severity, but does not enhance smoking cessation for participants with low baseline PTSD severity. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
RCT Entities:
BACKGROUND: Prevalence of smoking among individuals with posttraumatic stress disorder (PTSD) is disproportionately high, and PTSD is associated with especially poor response to smoking cessation treatment. OBJECTIVE: The current study examined whether integrating treatments for smoking cessation (varenicline plus smoking cessation counseling; VARCC) and PTSD (prolonged exposure therapy; PE) enhances smoking outcomes among smokers diagnosed with PTSD. METHOD: 142 adults with nicotine dependence (ND) and PTSD were randomized to a treatment program consisting of varenicline, smoking cessation counseling, and PE (VARCC + PE) or to VARCC only. Seven-day point prevalence abstinence (PPA) at posttreatment (3-months postquit day) and follow-up (6-months postquit day), verified by serum cotinine levels and exhaled carbon monoxide, was the primary smoking outcome. Psychological outcomes were PTSD and depression severity. Mixed effects models included baseline PTSD severity as a moderator of treatment condition effects. RESULTS: Overall, VARCC + PEparticipants did not show greater PPA than VARCC participants. However, treatment effects were moderated by baseline PTSD severity. For participants with moderate and high PTSD severity, VARCC + PE led to significantly higher PPA than VARCC alone (ps<.05). No differences between treatment conditions emerged for participants with low baseline PTSD severity. Participants who received PE showed significantly greater reduction of PTSD and depression symptoms than those who did not receive PE. CONCLUSIONS: Integrating psychological treatment for PTSD and smoking cessation treatment enhances smoking cessation for participants with moderate or severe PTSD symptom severity, but does not enhance smoking cessation for participants with low baseline PTSD severity. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Authors: Jasper A J Smits; Michael J Zvolensky; Michelle L Davis; David Rosenfield; Bess H Marcus; Timothy S Church; Mark B Powers; Georita M Frierson; Michael W Otto; Lindsey B Hopkins; Richard A Brown; Scarlett O Baird Journal: Psychosom Med Date: 2016-04 Impact factor: 4.312
Authors: Douglas E Jorenby; J Taylor Hays; Nancy A Rigotti; Salomon Azoulay; Eric J Watsky; Kathryn E Williams; Clare B Billing; Jason Gong; Karen R Reeves Journal: JAMA Date: 2006-07-05 Impact factor: 56.272
Authors: Miles McFall; Andrew J Saxon; Carol A Malte; Bruce Chow; Sara Bailey; Dewleen G Baker; Jean C Beckham; Kathy D Boardman; Timothy P Carmody; Anne M Joseph; Mark W Smith; Mei-Chiung Shih; Ying Lu; Mark Holodniy; Philip W Lavori Journal: JAMA Date: 2010-12-08 Impact factor: 56.272
Authors: Raymond F Anton; Stephanie S O'Malley; Domenic A Ciraulo; Ron A Cisler; David Couper; Dennis M Donovan; David R Gastfriend; James D Hosking; Bankole A Johnson; Joseph S LoCastro; Richard Longabaugh; Barbara J Mason; Margaret E Mattson; William R Miller; Helen M Pettinati; Carrie L Randall; Robert Swift; Roger D Weiss; Lauren D Williams; Allen Zweben Journal: JAMA Date: 2006-05-03 Impact factor: 56.272
Authors: Brittain L Mahaffey; Adam Gonzalez; Samantha G Farris; Michael J Zvolensky; Evelyn J Bromet; Benjamin J Luft; Roman Kotov Journal: Nicotine Tob Res Date: 2015-08-24 Impact factor: 4.244
Authors: Adam Gonzalez; Fred Friedberg; Xiaotong Li; Michael J Zvolensky; Evelyn J Bromet; Brittain L Mahaffey; Anka A Vujanovic; Benjamin J Luft; Roman Kotov Journal: Nicotine Tob Res Date: 2017-08-01 Impact factor: 4.244
Authors: Eva Kralikova; Alexandra Kmetova; Lenka Stepankova; Kamila Zvolska; Rachel Davis; Robert West Journal: Addiction Date: 2013-05-13 Impact factor: 6.526
Authors: Robert A Schnoll; Morgan Thompson; Katrina Serrano; Frank Leone; David Metzger; Ian Frank; Robert Gross; Karam Mounzer; Rachel F Tyndale; Jessica Weisbrot; Miles Meline; Ronald G Collman; Rebecca L Ashare Journal: J Acquir Immune Defic Syndr Date: 2019-02-01 Impact factor: 3.731
Authors: Sudie E Back; Therese Killeen; Christal L Badour; Julianne C Flanagan; Nicholas P Allan; Elizabeth Santa Ana; Brian Lozano; Kristina J Korte; Edna B Foa; Kathleen T Brady Journal: Addict Behav Date: 2018-11-27 Impact factor: 3.913
Authors: Joshua L Karelitz; Erin A McClure; Caitlin Wolford-Clevenger; Lauren R Pacek; Karen L Cropsey Journal: Drug Alcohol Depend Date: 2021-02-03 Impact factor: 4.492
Authors: Catherine R Ayers; Jaimee L Heffner; Cristina Russ; David Lawrence; Thomas McRae; A Eden Evins; Robert M Anthenelli Journal: Depress Anxiety Date: 2019-12-18 Impact factor: 6.505
Authors: Eric A Dedert; Patricia A Resick; Paul A Dennis; Sarah M Wilson; Scott D Moore; Jean C Beckham Journal: J Addict Med Date: 2019 Jul/Aug Impact factor: 4.647