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. 2013;9(1):87-93.
doi: 10.1080/15504263.2012.749559.

An Open Trial of Relapse Prevention Therapy for Smokers With Schizophrenia

Corinne Cather  1 , Michael A Dyer, Heather A Burrell, Bettina Hoeppner, Donald C Goff, A Eden Evins
Affiliations

An Open Trial of Relapse Prevention Therapy for Smokers With Schizophrenia

Corinne Cather et al. J Dual Diagn. 2013.

Abstract

Objective: Following successful smoking cessation, smokers with schizophrenia are vulnerable to relapse shortly after treatment discontinuation. Our objective was to assess the feasibility and effectiveness of a 12-month relapse prevention intervention in recently abstinent smokers with schizophrenia.

Method: Adult outpatient smokers with schizophrenia received weekly cognitive behavioral therapy groups, bupropion slow release, transdermal nicotine patch, and nicotine gum or lozenge for three months. Subjects with seven-day point prevalence abstinence at month 3 received an additional 12 months (months 4-15) of therapy with bupropion, transdermal nicotine patch, and nicotine gum/lozenge in conjunction with relapse prevention-based cognitive behavioral therapy groups that were held weekly in month 4, biweekly in months 5-6, and monthly in months 7-15.

Results: Seventeen of 41 participants (41.5%) attained biochemically verified self-report of seven-day point prevalence abstinence at the end of three months of treatment and entered relapse prevention treatment. There was an 81% attendance rate at relapse prevention groups. At the end of the 12-month relapse prevention phase (month 15 overall), 11 of 17 (64.7%) demonstrated biochemically verified seven-day point prevalence abstinence, and 10 of 17 (58.8%) reported four-week continuous abstinence. Almost one quarter of the sample (23.5%) demonstrated long-term prolonged abstinence through the end of the trial. There were no clinically detected cases of psychiatric symptom exacerbation. One participant, who was managed as an outpatient, self-reported psychiatric symptom exacerbation in the interim period between study visits.

Conclusions: Extended duration smoking cessation treatment is well-tolerated and may improve smoking outcomes for recently abstinent smokers with schizophrenia. Controlled trials are warranted.

Keywords: bupropion; cognitive behavioral therapy; nicotine replacement therapy; relapse prevention; schizophrenia; severe mental illness; smoking cessation.

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Figures

Figure 1
Figure 1
Schema of Study Visits
Figure 2
Figure 2
Abstinence Rates and Expired CO over 12-Month Intervention (N = 17). Note. CO = carbon monoxide; ppm = parts per million.
Figure 3
Figure 3
Survival function showing abstinence among participants using bupropion and nicotine gum/lozenge in the 12 month relapse prevention phase (starting at month 3 of the trial).
See this image and copyright information in PMC

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