Cigarette smoking is a prototypic case of drug dependence and a dominant cause of coronary heart disease (CHD). CHD is the leading cause of morbidity and mortality in the US. Of the half-million deaths annually attributed to CHD, about 245,000 occur among women. There is an urgent need to determine whether existing smoking cessation interventions are applicable to women since most research has been conducted in men. Identifying effective treatment of tobacco dependence in women with heart disease is a priority in light of the dramatic and immediate health benefits of quitting smoking. This study will compare two theoretically-based treatment interventions that have demonstrated some efficacy in the treatment of tobacco dependence. Hospitalized women N=60) with angiographically documented coronary artery disease will be randomly assigned to a cognitive- behavioral relapse prevention intervention or a health-educational counseling intervention. Both manual-driven intervention will begin during hospitalization and consist of eight weekly sessions conducted by trained therapists. The primary dependent measure will be self-reported tobacco use over a one-year follow-up period. Urine continue determinations will be used to corroborate these reports. Relapse prevention therapy is expected to yield better overall outcome via intensive practice of coping skills. Repeated assessment of patients assigned to these interventions will permit prospective evaluation of behavioral, psychological, and environmental correlates of short- and long-term smoking modification. This information, in combination with pretreatment assessment of smoking and health status, psychosocial functioning, cardiac health knowledge, ad coping skills, will be used to develop differential responder profiles indicating the most efficacious match of patient and therapy. Prospective outcome data from patients who quit without treatment assistance will be used as normative data against which treatment outcomes can be compared. This subgroup of """"""""self- quitters"""""""" will also provide valuable information concerning successful coping strategies for relapse prevention. This application: i) describe a careful study of theoretically based treatments for drug dependence, ii) answers previously neglected questions concerning smoking cessation and effective relapse prevention strategies for the treatment of tobacco/nicotine dependence in health- compromised women, and iii) provides a useful conceptual understanding and research design for treatment of other groups of high-risk drug dependent patients. These outcomes provide a foundation for achieving the national objectives of health promotion and disease prevention.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA008888-01
Application #
2121703
Study Section
Special Emphasis Panel (SRCD (53))
Project Start
1994-06-01
Project End
1997-03-31
Budget Start
1994-06-01
Budget End
1995-05-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
Houston
State
TX
Country
United States
Zip Code
77225
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Schmitz, Joy M; Stotts, Angela L; Mooney, Marc E et al. (2007) Bupropion and cognitive-behavioral therapy for smoking cessation in women. Nicotine Tob Res 9:699-709
Schmitz, Joy M; Sayre, Shelly L; Stotts, Angela L et al. (2005) Medication compliance during a smoking cessation clinical trial: a brief intervention using MEMS feedback. J Behav Med 28:139-47
Schmitz, Joy M (2003) Smoking cessation in women with cardiac risk. Am J Med Sci 326:192-6
Schmitz, J M; Spiga, R; Rhoades, H M et al. (1999) Smoking cessation in women with cardiac risk: a comparative study of two theoretically based therapies. Nicotine Tob Res 1:87-94
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