title: Efficacy of smoking cessation therapy alone or integrated with prolonged exposure therapy for smokers with PTSD: Study protocol for a randomized controlled trial.
abstract: Posttraumatic stress disorder (PTSD) is related to an increased risk of smoking cessation failure. In fact, the quit rate in smokers with PTSD (23.2%) is one of the lowest of all mental disorders. Features of PTSD that contribute to smokers' progression to nicotine dependence and cessation relapse include negative affect, fear, increased arousal, irritability, anger, distress intolerance, and anxiety sensitivity. Anxiety sensitivity is higher in people with PTSD than in any other anxiety disorder except for panic disorder. High anxiety sensitivity is uniquely associated with greater odds of lapse and relapse during quit attempts. Distress intolerance, a perceived or behavioral tendency to not tolerate distress, is related to both the maintenance of PTSD and problems in quitting smoking. Prolonged exposure (PE) and interoceptive exposure (IE) reduce PTSD symptoms, distress intolerance, and anxiety sensitivity. Thus, they emerge as promising candidates to augment standard smoking cessation interventions for individuals with PTSD. The present study tests a 12-session specialized treatment for smokers with PTSD. This Integrated PTSD and Smoking Treatment (IPST) combines cognitive-behavioral therapy and nicotine replacement treatment for smoking cessation (standard care; SC) with PE to target PTSD symptoms and IE to reduce anxiety sensitivity and distress intolerance. Adult smokers (N=80) with PTSD will be randomly assigned to either: (1) IPST or (2) SC. Primary outcomes are assessed at weeks 0, 6, 8, 10, 14, 16, 22, and 30.
authors: Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States. Electronic address: mbpowers@utexas.edu.
authors: Mark B
authors: MB
authors: Powers
authors: Department of Psychology, University of Houston, Houston, TX, United States.
authors: Brooke Y
authors: BY
authors: Kauffman
authors: Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States; Department of Psychology, Baylor University, Waco, TX, United States.
authors: Anne L
authors: AL
authors: Kleinsasser
authors: Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States.
authors: Eunjung
authors: E
authors: Lee-Furman
authors: Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States.
authors: Jasper A J
authors: JA
authors: Smits
authors: Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors: Michael J
authors: MJ
authors: Zvolensky
authors: Department of Psychology, Southern Methodist University, Dallas, TX, United States.
authors: David
authors: D
authors: Rosenfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012107:Research Design; D016540:Smoking Cessation / Q000379:methods*; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D061485:Tobacco Use Cessation Devices; D055815:Young Adult
keywords: Behavioral intervention; Clinical trial; PTSD; Smoking cessation