title: Pilot Cases of Combined Cognitive Processing Therapy and Smoking Cessation for Smokers With Posttraumatic Stress Disorder.
abstract: Posttraumatic stress disorder (PTSD) and smoking are often comorbid, and both problems are in need of improved access to evidence-based treatment. The combined approach could address two high-priority problems and increase patient access to both treatments, but research is needed to determine whether this is feasible and has promise for addressing both PTSD and smoking. We collected data from 15 test cases that received a treatment combining two evidence-based treatments: cognitive processing therapy-cognitive version (CPT-C) for PTSD and integrated care for smoking cessation (ICSC). We explored two combined treatment protocols including a brief (six-session) CPT-C with five follow-up in-person sessions focused on smoking cessation (n=9) and a full 12-session CPT-C protocol with ICSC (n=6). The combined interventions were feasible and acceptable to patients with PTSD making a quit attempt. Initial positive benefits of the combined treatments were observed. The six-session dose of CPT-C and smoking cessation resulted in 6-month bioverified smoking abstinence in two of nine participants, with clinically meaningful PTSD symptom reduction in three of nine participants. In the second cohort (full CPT-C and smoking treatment), both smoking and PTSD symptoms were improved, with three of six participants abstinent from smoking and four of six participants reporting clinically meaningful reduction in PTSD symptoms. Results suggested that individuals with PTSD who smoke are willing to engage in concurrent treatment of these problems and that combined treatment is feasible.
authors.affiliation: Durham Veterans Affairs Medical Center, Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center Duke University Medical Center. Electronic address: eric.dedert@duke.edu.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Dedert
authors.affiliation: Duke University Medical Center.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
authors.affiliation: VA Puget Sound Health Care System, Seattle Division, University of Washington, School of Medicine.
authors.forename: Miles E
authors.initials: ME
authors.lastname: McFall
authors.affiliation: Durham Veterans Affairs Medical Center and Duke University Medical Center.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Dennis
authors.affiliation: Center for Health Services Research in Primary Care, Durham VA Medical Center, Duke University School of Medicine.
authors.forename: Maren
authors.initials: M
authors.lastname: Olsen
authors.affiliation: Durham Veterans Affairs Medical Center, Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center Duke University Medical Center.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012907:Smoking / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*
keywords: cognitive therapy; comorbidity; posttraumatic stress disorder; psychotherapy; tobacco use cessation