title: Acceptance of nicotine dependence treatment among currently depressed smokers.
abstract: This study reports on baseline characteristics associated with acceptance and refusal of available smoking treatment among currently depressed smokers in a psychiatric outpatient clinic who were enrolled in a larger clinical trial. The sample (N=154) was 68% female and 72% White, with a mean age of 41.4 years and average smoking rate of 17 cigarettes/day. All participants were assigned to a repeated contact experimental condition; received a stage-based expert system program to facilitate treatment acceptance; and were then offered smoking treatment, consisting of behavioral counseling, nicotine patch, and bupropion. Acceptors (n=53) were defined as those accepting behavioral counseling and pharmacological treatment at some point during the 18-month study, whereas refusers (n=101) received only the expert system. The number of days to treatment acceptance was significantly predicted by stage of change, with those in preparation entering treatment more quickly than contemplators or precontemplators. In a logistic regression, the variables most strongly associated with accepting treatment were current use of psychiatric medication and perceived success for quitting. Severity of depressive symptoms, duration of depression history, and history of recurrent depression were not related to treatment acceptance. Findings have implications for the psychiatric assessment and treatment of smokers in clinical settings. Psychiatric medication may play a significant role in smoking cessation treatment acceptance by currently depressed smokers.
authors.affiliation: Department of Psychiatry, School of Medicine, University of California, San Francisco, USA. nahaug@itsa.ucsf.edu
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Haug
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Hall
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
authors.forename: Amy B
authors.initials: AB
authors.lastname: Rosen
authors.forename: Janice Y
authors.initials: JY
authors.lastname: Tsoh
authors.forename: Gary
authors.initials: G
authors.lastname: Humfleet
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Rossi
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Redding
authors.forename: Stuart
authors.initials: S
authors.lastname: Eisendrath
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000592:standards; D016642:Bupropion / Q000008:administration & dosage; D003155:Community Mental Health Centers; D003376:Counseling / Q000592:standards; D003863:Depression / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012495:San Francisco / Q000453:epidemiology; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*
chemical_list: D018765:Dopamine Uptake Inhibitors; D016642:Bupropion