Qualitative Review of a Dialectical Behavior Therapy - Skills Training Intervention for Cigarette Smoking by Patients...

Despite evidence that quitting smoking improves cancer treatment and outcomes, about one in eight patients with cancer smokes cigarettes. Current cessation approaches may not effectively address this population's psychosocial barriers to quitting, such as psychological distress and emotion dysregulation related to cancer diagnosis and treatment. To improve self-efficacy for quitting, we developed a brief virtual group intervention to teach patients skills in emotion regulation and distress tolerance using Dialectical Behavior Therapy - Skills Training (DBT-ST), a psychotherapeutic approach that has been applied successfully to improve coping skills and outcomes for patients with substance use disorders and patients with breast cancer but has not been applied to smoking among cancer populations. To enhance our intervention prior to a feasibility clinical trial, we obtained qualitative feedback from patients and clinicians.

We conducted qualitative interviews with patients with cancer who smoked or had quit and oncology physicians, psychotherapists, and nurses ( n =17, 53% female, 82% White, average age=52.3). After reaching data saturation, we analyzed interviews using thematic analysis.

Participants strongly supported the intervention for smoking cessation, notably the group format and DBT-ST skills for being present, managing emotions, and handling stress, while sharing mixed opinions on other components such as the virtual setting. Additional perceived benefits were improved quality of life, decreased anxiety and depression, and acquisition of universal skills for managing life's challenges.

These results indicate early enthusiasm and promise for our DBT-ST brief intervention for patients with cancer who smoke cigarettes, while suggesting modifications prior to a feasibility trial.

Research into effective smoking cessation strategies for patients with cancer is a national priority. This study found that patients with cancer and their clinicians support our new cessation program, adapted from Dialectical Behavior Therapy - Skills Training, for teaching critical skills in managing emotions and stress so that patients with cancer can quit smoking and not relapse. We used their suggestions to improve our program prior to testing it in a clinical trial.