Effectiveness of cognitive-behavioral therapy for smokers with histories of alcohol dependence and depression.
OBJECTIVE
Alcohol dependence and major depression have been associated with heavy cigarette use and poor smoking-treatment outcomes. This preliminary study examined the efficacy of a mood management intervention for smoking cessation in abstinent alcoholics with a history of major depression.


METHODS
Participants were 29 (15 female, 14 male) heavy smokers (mean cigs/day = 30.2), with an average of 6.8 years of continuous abstinence from alcohol and drugs, randomized to behavioral counseling (BC) (n = 16) or behavioral counseling + cognitive-behavioral mood management (CBT) (n = 13). A 2 x 5 repeated measures design was used to evaluate the effectiveness of the interventions on smoking outcome at baseline, posttreatment and at 1-, 3- and 12-month-follow-up. Self-reported smoking status was verified with biochemical (COa) and informant report.


RESULTS
Verified self-report indicated that significantly more smokers in CBT quit by posttreatment (69.2%; 9 of 13) than in BC (31.3%; 5 of 16) (chi2 = 4.14, 1 df, p = .04). These abstinence rates remained unchanged at 1-month follow-up. At 3-month follow-up, differences in smoking abstinence rates were nonsignificant between CBT (46.2%; 6 of 13) and BC (25.0%; 4 of 16) conditions. However, at 12-month follow-up, significantly more participants in CBT were abstinent from smoking (46.2%; 6 of 13) than in BC (12.5%; 2 of 16) (chi2 = 4.07, 1 df, p = .04).


CONCLUSIONS
The results suggest that interventions focused on managing negative mood may benefit these high-risk, comorbid smokers.
Patten
C A
CA
San Diego State University, School of Medicine Joint Doctoral Program in Clinical Psychology, California 92122, USA.
Martin
J E
JE
Myers
M G
MG
Calfas
K J
KJ
Williams
C D
CD
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D001521:Behavior Therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000523:psychology*; D016896:Treatment Outcome