EFFECTIVENESS OF COGNITIVE-BEHAVIORAL THERAPY FOR SMOKERS WITH HISTORIES OF ALCOHOL DEPENDENCE AND DEPRESSION

Objective: Alcohol dependence and major depression have been associate d with heavy cigarette use and poor smoking-treatment outcomes. This p reliminary study examined the efficacy of a mood management interventi on for smoking cessation in abstinent alcoholics with a history of maj or depression. Method: Participants were 29 (15 female, 14 male) heavy smokers (mean cigs/day = 30.2), with an average of 6.8 years of conti nuous abstinence from alcohol and drugs, randomized to behavioral coun seling (BC) (n = 16) or behavioral counseling + cognitive-behavioral m ood management (CBT) (n = 13). A 2 x 5 repeated measures design was us ed to evaluate the effectiveness of the interventions on smoking outco me at baseline, posttreatment and at 1-, 3- and 12-month-follow-up. Se lf-reported smoking status was verified with biochemical (COa) and inf ormant report. Results: Verified self-report indicated that significan tly more smokers in CBT quit by posttreatment (69.2%; 9 of 13) than in BC (31.3%; 5 of 16) (chi(2) = 4.14, 1 df, p = .04). These abstinence rates remained unchanged at 1-month follow-up. At 3-month follow-up, d ifferences in smoking abstinence rates were nonsignificant between CBT (46.2%; 6 of 13) and BC (25.0%; 4 of 16) conditions. However, at 12-m onth follow-up, significantly more participants in CBT were abstinent from smoking (46.2%; 6 of 13) than in BC (12.5%; 2 of 16) (chi(2) = 4. 07, 1 df, p = .04). Conclusions: The results suggest that intervention s focused on managing negative mood may benefit these high-risk, comor bid smokers.