title: Acceptance and commitment therapy smoking cessation treatment for veterans with posttraumatic stress disorder: a pilot study.
abstract: OBJECTIVE
  Veterans with PTSD smoke at rates two to three times higher than the general population, while their quit rate is less than half that of the general population. The present study evaluated the feasibility, acceptability, and preliminary efficacy of Acceptance and Commitment Therapy for Veterans With Posttraumatic Stress Disorder (PTSD) and Tobacco Addiction (ACT-PT), which focuses on helping veterans overcome emotional challenges to quitting smoking.
  
  
  METHODS
  Veterans with current PTSD who smoked 15 or more cigarettes/day (N = 19) participated in an open trial of ACT-PT. Participants attended nine weekly individual counseling sessions and received eight weeks of nicotine patch therapy. Primary outcomes included feasibility and acceptability of the intervention, and secondary outcomes included expired-air carbon monoxide confirmed seven-day point prevalence abstinence, cravings, and PTSD symptoms.
  
  
  RESULTS
  The retention rate for ACT-PT was good (74%) and client satisfaction ratings were high. Participants made multiple quit attempts (M = 3.6, SD = 4.2) during the study period and were significantly more confident that they could quit smoking at three-month follow-up. At the end of treatment, 37% of participants were abstinent from smoking and 16% were abstinent at three-month follow-up. Overall, participants reduced their smoking by 62% at the end of treatment and 43% at three-month follow-up. PTSD symptoms and smoking urges significantly decreased from baseline to the end of treatment and three-month follow-up.
  
  
  CONCLUSIONS
  ACT-PT appears to be a promising smoking cessation treatment for veterans with PTSD. Future research should evaluate ACT-PT in a randomized controlled trial.
authors.affiliation: a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Kelly
authors.forename: Hannah
authors.initials: H
authors.lastname: Sido
authors.forename: John P
authors.initials: JP
authors.lastname: Forsyth
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Ziedonis
authors.forename: David
authors.initials: D
authors.lastname: Kalman
authors.forename: Judith L
authors.initials: JL
authors.lastname: Cooney
mesh_terms: D064869:Acceptance and Commitment Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010865:Pilot Projects; D016540:Smoking Cessation / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
keywords: acceptance; mindfulness; posttraumatic stress disorder; smoking cessation; tobacco