Format

Send to

Choose Destination
BMC Public Health. 2017 Apr 17;17(1):323. doi: 10.1186/s12889-017-4250-7.

Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial.

Author information

1
The Miriam Hospital, Providence, RI, USA. Andrew.Busch@hcmed.org.
2
Warren Alpert Medical School of Brown University, Providence, RI, USA. Andrew.Busch@hcmed.org.
3
Current correspondence address, Minneapolis Medical Research Foundation, 701 Park Avenue, S9-309, Minneapolis, MN, 55415-1623, USA. Andrew.Busch@hcmed.org.
4
Roger Williams University, Bristol, RI, USA.
5
The Miriam Hospital, Providence, RI, USA.
6
Brown University School of Public Health, Providence, RI, USA.
7
Warren Alpert Medical School of Brown University, Providence, RI, USA.
8
Providence VA Medical Center, Providence, RI, USA.
9
Rhode Island Hospital, Providence, RI, USA.
10
University of Massachusetts Medical School, Worcester, MA, USA.
11
Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA.

Abstract

BACKGROUND:

Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC).

METHODS:

Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up.

RESULTS:

Fifty-nine participants (28 BAT-CS, 31 SC) were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41-3.93) for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42-3.82) for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03). At 24-weeks, effect sizes for mood and stress outcomes ranged from η2partial of.07-.11, with significant between treatment effects for positive affect, negative affect, and stress.

CONCLUSIONS:

The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted.

TRIAL REGISTRATION:

NCT01964898 . First received by clinicaltrials.gov October 15, 2013.

KEYWORDS:

Acute coronary syndrome; Behavioral activation; Cessation; Depression; Mood; Smoking

PMID:
28415979
PMCID:
PMC5392972
DOI:
10.1186/s12889-017-4250-7
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center