Category: PTSD

Symposium

The Efficacy of Smoking Cessation Alone or Integrated With Prolonged Exposure Therapy for Smokers With PTSD

Saturday, November 18
12:00 PM - 1:30 PM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: PTSD Posttraumatic Stress Disorder | Smoking | Anxiety Sensitivity
Presentation Type: Symposium

Post-traumatic stress disorder (PTSD) is related to a significantly 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 may 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 persons 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. Fear extinction-based treatments (i.e., prolonged exposure [PE], interoceptive exposure [IE]) have shown efficacy for reducing PTSD and distress intolerance and anxiety sensitivity and therefore emerge as promising candidates to augment standard smoking cessation interventions for individuals with PTSD. The present study pilot tests a 12-session integrated and 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 (e.g., negative affect, fear, increased arousal, irritability, anger) and IE to reduce anxiety sensitivity and distress intolerance. Adult smokers (N = 64, 39 females, MAge = 38) with PTSD were randomly assigned to either: (1) IPST or (2) SC. Smoking outcomes were assessed 2, 4, 10, and 18 weeks after quit date. Measure of putative mediators will be assessed repeatedly prior and following the quit date. Consistent with prediction, quit rates were higher in the combined treatment compared to smoking cessation alone (p < .05). 

Mark B. Powers

Research Associate Professor
University of Texas at Austin

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The Efficacy of Smoking Cessation Alone or Integrated With Prolonged Exposure Therapy for Smokers With PTSD



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