Preliminary Trial of a Behavioral Activation-Enhanced Smoking Cessation Program among Substance Users with Elevated Depressive Symptoms in Residential Treatment

Abstract

Individuals with elevated depressive symptoms and substance use disorders (SUDs) have particular difficulties quitting smoking and few treatments benefit these individuals. The current study compared five session BA-enhanced smoking cessation treatment + nicotine replacement therapy (BADAS) to smoking cessation treatment as usual (TAU; nicotine replacement therapy + Clearing the Air self-help manual). We hypothesized that participants in BADAS would be less likely to relapse, would have higher abstinence rates, would smoke fewer cigarettes, would exhibit decreases in depressive symptoms, and would have increases in environmental reward, as compared to TAU. Participants in residential treatment with elevated depressive symptoms and SUDs and were randomized to BADAS or to TAU. Participants in BADAS were significantly less likely to relapse during the first week post-quit; abstinence and cigarette consumption rates did not differ significantly across treatments. All participants displayed reductions in depressive symptoms and increases in activation; treatment condition was not significant.