Cigarette smoking is the leading cause of death and disability in the United States. Moreover, depression- related vulnerabilities are highly comorbid with smoking behavior and dramatically reduce cessation rates among both community and clinical samples. Previous research has examined the efficacy of integrating cognitive-behavioral treatment for depression into standard smoking cessation treatment focusing on individuals who have a past history of major depressive disorder (MDD). However, success has been limited in focusing on MDD history. A broader health impact can be achieved by targeting individuals with current elevated depressive symptoms given their association with cessation failure. Furthermore, the complexity of cognitive behavioral approaches for depression may impair their effective integration into smoking cessation protocols. As a result, new approaches to smoking cessation are needed for smokers with currently elevated depressive symptoms. We have recently completed an initial randomized controlled trial comparing an integrated novel behavioral activation smoking cessation treatment (BATS) versus standard smoking cessation treatment (ST) [with both conditions receiving 8 weeks of transdermal nicotine patch (TNP)] among smokers with elevated depressive symptoms. Preliminary findings indicate that in the first week post quit date, participants receiving BATS (n = 26) were 2.7 times more likely to be abstinent (p <.05) than ST (n = 16) participants. BATS participants also evidenced significantly higher (p = .02) abstinence rates than ST participants throughout the 26 week post-quit follow-up period. Preliminary results are encouraging and support a larger Stage II randomized controlled trial in order to better establish BATS as an efficacious treatment for smokers with depression-relevant vulnerabilities. Of further relevance, participants in this study were predominantly low income, minority individuals. This is important given considerable documented barriers to cessation and lower cessation rates for this at-risk group. Thus, the objective of the present proposal is to follow-up on our previous Stage I treatment development efforts and small scale randomized controlled trial (RCT) with a Stage II RCT comparing BATS to ST among a similar sample of 200 predominantly low income and minority smokers with elevated depressive symptoms. Treatments will be equated for participant and therapist contact time. Participants will be followed over 52 weeks post-quit date and the larger sample size will allow for more complex analyses of the mechanisms underlying cessation outcomes. We expect that as a result of this project, we will have provided evidence for the efficacy of a well-specified, novel behavioral activation smoking treatment that works well with smokers at significant risk for relapse.

Public Health Relevance

Smokers with depression-relevant vulnerabilities smoke at high rates and have poor cessation outcomes, yet smoking treatments specifically meeting the needs of these individuals have typically been limited to MDD history rather than current symptomatology. The objective of the current proposal is to continue our program of NIDA-funded research starting with a Behavioral Therapy Development Grant (R01DA18730) by conducting a Stage II RCT comparing behavioral activation therapy for smoking (BATS) to standard smoking cessation treatment (ST) for smokers with elevated depressive symptoms.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
3R01DA018730-04A1S1
Application #
8207437
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Grossman, Debra
Project Start
2005-09-30
Project End
2014-05-31
Budget Start
2011-01-01
Budget End
2011-05-31
Support Year
4
Fiscal Year
2011
Total Cost
$37,790
Indirect Cost
Name
University of Maryland College Park
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
790934285
City
College Park
State
MD
Country
United States
Zip Code
20742
Iwamoto, Derek Kenji; Corbin, William; Lejuez, Carl et al. (2014) College Men and Alcohol Use: Positive Alcohol Expectancies as a Mediator Between Distinct Masculine Norms and Alcohol Use. Psychol Men Masc 15:29-39
Banducci, Anne N; Lejuez, C W; MacPherson, Laura (2013) Pilot of a Behavioral Activation-Enhanced Smoking Cessation Program for Substance Users With Elevated Depressive Symptoms in Residential Treatment. Addict Newsl Am Psychol Div 50 2013:16-20
Iwamoto, Derek K; Smiler, Andrew P (2013) Alcohol makes you macho and helps you make friends: the role of masculine norms and peer pressure in adolescent boys' and girls' alcohol use. Subst Use Misuse 48:371-8
Amstadter, Ananda B; Daughters, Stacey B; Macpherson, Laura et al. (2012) Genetic associations with performance on a behavioral measure of distress intolerance. J Psychiatr Res 46:87-94
Iwamoto, Derek; Takamatsu, Stephanie; Castellanos, Jeanett (2012) Binge drinking and alcohol-related problems among U.S.-born Asian Americans. Cultur Divers Ethnic Minor Psychol 18:219-27
Amstadter, Ananda B; Macpherson, Laura; Wang, Frances et al. (2012) The relationship between risk-taking propensity and the COMT Val(158)Met polymorphism among early adolescents as a function of sex. J Psychiatr Res 46:940-5
De Los Reyes, Andres; Thomas, Sarah A; Swan, Anna J et al. (2012) ""It Depends on What You Mean by 'Disagree'"": Differences between Parent and Child Perceptions of Parent-Child Conflict. J Psychopathol Behav Assess 34:293-307
Iwamoto, Derek Kenji; Gordon, Derrick; Oliveros, Arazais et al. (2012) The Role of Masculine Norms and Informal Support on Mental Health in Incarcerated Men. Psychol Men Masc 13:283-293
Iwamoto, Derek Kenji; Cheng, Alice; Lee, Christina S et al. (2011) ""Man-ing"" up and getting drunk: the role of masculine norms, alcohol intoxication and alcohol-related problems among college men. Addict Behav 36:906-11
Iwamoto, Derek; Liu, William Ming; McCoy, Thomasin E (2011) An exploratory model of substance use among Asian American women: the role of depression, coping, peer use and Asian values. J Ethn Subst Abuse 10:295-315

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