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. 2019 Mar:90:136-142.
doi: 10.1016/j.addbeh.2018.10.042. Epub 2018 Oct 29.

Contingency management and cognitive behavioral therapy for trauma-exposed smokers with and without posttraumatic stress disorder

Sandra J Japuntich  1 , Lewina O Lee  2 , Suzanne L Pineles  3 , Kristin Gregor  2 , Celina M Joos  4 , Samantha C Patton  4 , Suchitra Krishnan-Sarin  5 , Ann M Rasmusson  3
Affiliations

Contingency management and cognitive behavioral therapy for trauma-exposed smokers with and without posttraumatic stress disorder

Sandra J Japuntich et al. Addict Behav. 2019 Mar.

Abstract

Introduction: Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) are more likely to smoke and less successful in quit attempts than individuals without psychopathology. Contingency management (CM) techniques (i.e., incentives for abstinence) have demonstrable efficacy for smoking cessation in some populations with psychopathology, but have not been well tested in PTSD. This pilot study examined the feasibility of CM plus brief cognitive behavioral therapy (CBT) in promoting smoking cessation among trauma-exposed individuals with and without PTSD.

Methods: Fifty trauma-exposed smokers (18 with PTSD) were asked to abstain from tobacco and nicotine replacement therapy for one month. During week one of cessation, CBT was provided daily and increasing CM stipends were paid for each continuous day of biochemically-verified abstinence; CM stipends were withheld in response to smoking lapses and reset to the initial payment level upon abstinence resumption. CBT and fixed payments for study visits were provided during the subsequent three weeks.

Results: Of the 50 eligible participants who attended at least one pre-quit visit (49% female, 35% current PTSD), 43 (86%) attended the first post-quit study visit, 32 (64%) completed the first week of CM/CBT treatment, and 26 (52%) completed the study. Post-quit seven-day point prevalence abstinence rates for participants with and without PTSD, respectively, were similar: 39% vs. 38% (1 week), 33% vs. 28% (2 weeks), 22% vs. 19% (3 weeks), and 22% vs. 13% (4 weeks).

Conclusions: Use of CM + CBT to support tobacco abstinence is a promising intervention for trauma-exposed smokers with and without PTSD.

Keywords: Contingency management; Post-traumatic; Psychological trauma; Stress disorders; Tobacco use cessation; Tobacco use disorder.

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Conflict of interest statement

DECLARATION OF INTERESTS

Dr. Rasmusson has been a paid consultant to Resilience Therapeutics and Cohen Veterans Bioscience over the past three years. The authors otherwise declare that there are no potential conflicts of interest to report. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Conflict of Interest

The authors declare that there are no conflicts of interest.

Figures

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Fig. 1.
Participant flow.
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References

    1. Alessi SM, Petry NM, & Urso J (2008). Contingency management promotes smoking reductions in residential substance abuse patients. Journal of Applied Behavior Analysis, 41(4), 617–622. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19192865 - PMC - PubMed
    1. Alessi SM, Rash CJ, & Petry NM (2017). A Randomized Trial of Adjunct mHealth Abstinence Reinforcement With Transdermal Nicotine and Counseling for Smoking Cessation. Nicotine Tob Res, 19(3), 290–298. doi: 10.1093/ntr/ntw155 - DOI - PMC - PubMed
    1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM IV-TR. Washington, DC: American Psychiatric Association.
    1. Biener L, & Abrams DB (1991). The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychology, 10(5), 360–365. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1935872 - PubMed
    1. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, & Keane TM (1995). The development of a Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 8(1), 75–90. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7712061 - PubMed

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