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. 2016 Jan;47(1):54-65.
doi: 10.1016/j.beth.2015.09.002. Epub 2015 Sep 25.

Pilot Cases of Combined Cognitive Processing Therapy and Smoking Cessation for Smokers With Posttraumatic Stress Disorder

Eric A Dedert  1 , Patricia A Resick  2 , Miles E McFall  3 , Paul A Dennis  4 , Maren Olsen  5 , Jean C Beckham  6
Affiliations

Pilot Cases of Combined Cognitive Processing Therapy and Smoking Cessation for Smokers With Posttraumatic Stress Disorder

Eric A Dedert et al. Behav Ther. 2016 Jan.

Abstract

Posttraumatic stress disorder (PTSD) and smoking are often comorbid, and both problems are in need of improved access to evidence-based treatment. The combined approach could address two high-priority problems and increase patient access to both treatments, but research is needed to determine whether this is feasible and has promise for addressing both PTSD and smoking. We collected data from 15 test cases that received a treatment combining two evidence-based treatments: cognitive processing therapy-cognitive version (CPT-C) for PTSD and integrated care for smoking cessation (ICSC). We explored two combined treatment protocols including a brief (six-session) CPT-C with five follow-up in-person sessions focused on smoking cessation (n=9) and a full 12-session CPT-C protocol with ICSC (n=6). The combined interventions were feasible and acceptable to patients with PTSD making a quit attempt. Initial positive benefits of the combined treatments were observed. The six-session dose of CPT-C and smoking cessation resulted in 6-month bioverified smoking abstinence in two of nine participants, with clinically meaningful PTSD symptom reduction in three of nine participants. In the second cohort (full CPT-C and smoking treatment), both smoking and PTSD symptoms were improved, with three of six participants abstinent from smoking and four of six participants reporting clinically meaningful reduction in PTSD symptoms. Results suggested that individuals with PTSD who smoke are willing to engage in concurrent treatment of these problems and that combined treatment is feasible.

Keywords: cognitive therapy; comorbidity; posttraumatic stress disorder; psychotherapy; tobacco use cessation.

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Figures

Figure 1
Figure 1. PTSD Symptom Totals For Smokers Abstinent vs. Relapsed at 6 Months
PCL-S scores throughout the course of treatment and 6-month follow-up across both Brief and Full treatment. The symptom course is represented for those who were ultimately abstinent at 6 months separately from those who relapsed.
See this image and copyright information in PMC

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