Cigarette smoking remains a leading cause of preventable death1, contributing to over 480,000 deaths each year2. Although efficacious, standard care for smoking cessation is associated with high non-response rates, suggesting there is a need to develop augmentation strategies3. Theory and empirical findings suggest that targeting automated, impulsive, implicit processes may hold promise4?9. Specifically, retraining approach bias, or the approach action tendency toward stimuli related to the substance of interest has been effective in alcohol use disorders (i.e., reduction in relapse rates by 10%-13%)10?13. We recently extended this work to smoking by demonstrating that approach bias retraining reduced approach bias and the reduction in approach bias was associated with the number of days quit in the week following a self-guided quit attempt14. The goal of this application is to pilot test an intervention that integrates approach bias retraining with standard care for smoking cessation. The integrated intervention involves seven weekly 60-minute sessions. Each session involves 15 minutes of computerized approach bias retraining followed by 45 minutes of individual CBT. The target quit week is set at week 5, at which time nicotine replacement therapy is prescribed. Adult smokers (N=100) will be recruited and randomly assigned to (1) the integrated intervention or (2) a control intervention that combines standard smoking cessation care as described above with a computerized intervention that does not target approach bias. Abstinence will be assessed during the intervention (weeks 0- 7), at posttreatment (week 8), and at 1-month (week 9), 2-month (week 13) and 3-month (week 17) follow-up (i.e., post-quit). Measures of putative mediators will be assessed during the intervention (weeks 0-7). The proposed study represents a crucial and important stage in translating basic research to strategies for treating nicotine dependence. The investigation addresses an important public health issue by testing an integrated intervention - informed by basic research - that may lead to a more effective treatment for at-risk smokers while simulatenously isolating explanatory mechanisms. The expected findings should: (1) guide advances in the theoretical conceptualization of the mechanisms involved smoking; and (2) provide initial effect size data for the integrated smoking cessation intervention, and thus provide the necessary data for a large- scale follow-up trial.
Smoking remains a significant public health problem and there is a need for more effective interventions. Theory and initial empirical findings justify testing whether a simple computerized intervention targeting the approach action tendency ? or approach bias ? toward stimuli related to cigarette smoking can augment smoking cessation. The goal of the current research is to evaluate the potential efficacy of an intervention that integrates this computerized intervention with standard smoking cessation care.
