Enhanced Smoking Cessation Intervention for Smokers Exposed to the WTC Disaster
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cigarette Smoking
- Sponsor
- Stony Brook University
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Session 8 7-day point prevalence cigarette abstinence
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
The purpose of this study was to test the efficacy of a CBT-based smoking cessation treatment enhanced with transdiagnostic skills for the management of anxiety and fear-based avoidance behaviors (CBT-A) relative to a standard CBT-based smoking cessation treatment (CBT-S) for smokers with elevated PTSD symptoms who were exposed to the 9/11 World Trade Center disaster. The investigators hypothesized that the CBT-A treatment would yield more favorable outcomes with regard to smoking abstinence as well as improvements in PTSD and respiratory symptoms over a 6-month follow-up period.
Detailed Description
Respiratory illness and post-traumatic stress disorder (PTSD) are the primary health sequelae of the World Trade Center (WTC) disaster on September 11th 2001 and are often comorbid. Cigarette smoking is a modifiable health behavior associated with both lower respiratory symptoms (LRS) and PTSD. Smoking cessation programs are considered the crucial front-line intervention for smokers with pulmonary problems. Unfortunately, trauma exposed smokers with elevated PTSD symptoms have greater difficulty quitting, are more likely to fail standard cessation programs, and are more likely to relapse than smokers with other anxiety disorders and those without mental illness. Interventions that concurrently target mechanisms thought to maintain the comorbidity between PTSD and LRS (e.g., anxious reactivity to nicotine withdrawal, smoking to reduce negative affect) may offer a means of improving smoking quit rates in trauma exposed populations. Thus, the purpose of this study was to test the efficacy of a combined CBT smoking cessation treatment enhanced with transdiagnostic skills for the management of anxiety and fear-based avoidance behaviors (CBT-A). The investigators randomized 90 WTC disaster exposed daily smokers with elevated PTSD symptoms to either CBT-A (N=44) or a standard CBT-based smoking cessation program (CBT-S; N=46). Participants were followed up to six months post-treatment.
Investigators
Eligibility Criteria
Inclusion Criteria
- •smoking at least five cigarettes per day
- •reporting interest in smoking cessation treatment
- •direct exposure to the WTC disaster (e.g., responding to the event or witnessing the event in person)
- •scoring \>30 on the Posttraumatic Stress Disorder Checklist
Exclusion Criteria
- •current participation in another smoking cessation treatment
- •alcohol dependence within the last six months
- •serious mental illness (e.g., psychosis, mania)
Outcomes
Primary Outcomes
Session 8 7-day point prevalence cigarette abstinence
Time Frame: Session 8: on average 2 weeks post-quit day
A dichotomized outcome (yes/no) configured based on biochemically verified 7 day smoking abstinence via Saliva cotinine (cutoff value of 10 ng/ml) and carbon monoxide (CO) analysis of breath samples with a Vitalograph Breathco CO monitor.
6-month Follow-up 7-day point prevalence cigarette abstinence
Time Frame: 6-month follow-up
A dichotomized outcome (yes/no) configured based on biochemically verified 7 day smoking abstinence via Saliva cotinine (cutoff value of 10 ng/ml) and carbon monoxide (CO) analysis of breath samples with a Vitalograph Breathco CO monitor.
Secondary Outcomes
- Change in WTC related post-traumatic stress disorder (PTSD) symptoms(Baseline and 2-weeks post-quit attempt)
- 6-month change in WTC related post-traumatic stress disorder (PTSD) symptoms(Baseline and 6-month follow-up)
- Change in lower respiratory symptoms(Baseline and 2-weeks post-quit attempt)
- 6-month change in lower respiratory symptoms(Baseline and 6-month follow-up)
- Change in average daily cigarettes smoked(Baseline and 2-weeks post-quit attempt)
- 6-month change in average daily cigarettes smoked(Baseline and 6-month follow-up)