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Cognitive-behavioral treatment for depression in smoking cessation
R A Brown1, C W Kahler, R Niaura
1Department of Psychiatry and Human Behavior, Brown University School of Medicine, Butler Hospital, Providence, Rhode Island 02906, USA. richard_brown@brown.edu
Journal of Consulting and Clinical Psychology
|August 10, 2001
Summary
Cognitive-behavioral treatment for depression (CBT-D) improved smoking cessation for smokers with a history of major depressive disorder (MDD), particularly those with recurrent depression or heavy smoking habits. Standard treatment alone was less effective for these specific groups.
Area of Science:
- Psychiatry
- Behavioral Science
- Addiction Medicine
Background:
- Major depressive disorder (MDD) is a significant risk factor for nicotine dependence.
- Effective smoking cessation strategies for individuals with a history of MDD are crucial.
- Standard smoking cessation treatments may not fully address the complexities of comorbid depression.
Purpose of the Study:
- To evaluate the efficacy of adding cognitive-behavioral treatment for depression (CBT-D) to standard smoking cessation treatment (ST) for smokers with past MDD.
- To identify specific subgroups of smokers with MDD who may benefit more from combined treatment.
Main Methods:
- A randomized controlled trial comparing ST alone versus ST plus CBT-D in adult cigarette smokers with a history of MDD.
- Participants received 8 group sessions of their assigned treatment.
- Smoking abstinence was assessed at 1-year follow-up.
Main Results:
- Overall abstinence rates at 1 year were 24.7% for ST and 32.5% for ST + CBT-D, with no statistically significant main effect of treatment.
- Secondary analyses revealed significant interactions: smokers with recurrent MDD and heavy smokers (≥25 cigarettes/day) who received ST + CBT-D had higher abstinence rates (ORs = 2.3 and 2.6, respectively) compared to those receiving ST.
- No significant benefits of CBT-D were observed for smokers without recurrent depression or those who were not heavy smokers.
Conclusions:
- Cognitive-behavioral treatment for depression (CBT-D) combined with standard smoking cessation treatment (ST) offers specific benefits for certain subgroups of smokers with a history of major depressive disorder (MDD).
- Smokers with a history of recurrent MDD and heavy smokers appear to derive greater smoking cessation success from the addition of CBT-D.
- Tailoring smoking cessation interventions based on depression history and smoking severity may enhance treatment effectiveness for individuals with comorbid MDD.