title: Trauma-Focused Smoking Cessation for Smokers Exposed to the World Trade Center Disaster: A Randomized Clinical Trial.
abstract: BACKGROUND
  The main objective was to evaluate the efficacy of an 8-session, group-based comprehensive smoking cessation and trauma management (CSC-T) treatment among daily smokers (≥5 cigarettes/day) exposed to the World Trade Center (WTC) disaster with elevated WTC-related post-traumatic stress disorder (PTSD) symptoms.
  
  
  METHODS
  Participants (N = 90) were randomly assigned to CSC-T (N = 44; 63.6% white; 27.3% female; mean age = 51.32 ± 7.87) or comprehensive smoking cessation (CSC) alone (N = 46; 71.7% white; 28.3% female; mean age = 48.74 ± 10.66), which was comparable in length and time. Assessments included a diagnostic clinical interview and self-report measures of PTSD and respiratory symptoms, and smoking behavior, and biologically confirmed smoking abstinence. Evaluations occurred at a baseline visit, each treatment session, and at 1-, 2-, 4-, 12-, and 26-weeks post-treatment.
  
  
  RESULTS
  The two treatments did not differ in regard to PTSD symptom improvement. After quit day (week 6), the two groups had similar 7-day (~15%) and 6-month (~20%) abstinence rates as well as average number of cigarettes smoked, and PTSD and respiratory symptoms.
  
  
  CONCLUSIONS
  It is possible that the Cognitive Behavioral Therapy skills specific to quitting smoking, group-based support, and degree of therapist contact, that were available in both treatments may have played a role in equalizing the abstinence rates between the two conditions. Although the current study found no evidence that the CSC-T was superior to the CSC alone treatment, the abstinence rates observed were high relative to previous trials of smokers with diagnosed PTSD. Further development of smoking cessation programs tailored to the needs of smokers with PTSD symptoms continues to be needed.
  
  
  CONCLUSIONS
  This study suggests that a CSC program aids in smoking abstinence for smokers with PTSD symptoms and that incorporating trauma management skills, may not add additional benefits for abstinence and PTSD and respiratory symptom relief. Further work is needed to improve smoking cessation efforts for smokers with PTSD symptoms.
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Adam
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Fred
authors.initials: F
authors.lastname: Friedberg
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Psychology, University of Houston, Houston, TX.|Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Brittain L
authors.initials: BL
authors.lastname: Mahaffey
authors.affiliation: Department of Psychology, University of Houston, Houston, TX.|Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.affiliation: Department of Medicine, Stony Brook University, Stony Brook, NY.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Luft
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY.
authors.forename: Roman
authors.initials: R
authors.lastname: Kotov
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047851:September 11 Terrorist Attacks; D000074285:Smokers; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*