Cognitive-behavioral treatment with behavioral activation for smoking cessation: Randomized controlled trial

Carmela Martínez-Vispo; Rubén Rodríguez-Cano; Ana López-Durán; Carmen Senra; Elena Fernández Del Río; Elisardo Becoña

doi:10.1371/journal.pone.0214252

Cognitive-behavioral treatment with behavioral activation for smoking cessation: Randomized controlled trial

PLoS One. 2019 Apr 8;14(4):e0214252. doi: 10.1371/journal.pone.0214252. eCollection 2019.

Authors

Carmela Martínez-Vispo¹, Rubén Rodríguez-Cano¹, Ana López-Durán¹, Carmen Senra², Elena Fernández Del Río³, Elisardo Becoña¹

Affiliations

¹ Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain.
² Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain.
³ Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.

Abstract

Introduction: Behavioral Activation is a behavioral-based treatment that has been proposed as suitable for smoking cessation, as it simultaneously addresses reinforcement-related variables and also mood management. The aim of this study was to compare the effects of a cognitive-behavioral smoking cessation treatment with components of behavioral activation (SCBSCT-BA) with a standard cognitive-behavioral treatment (SCBSCT), and a wait-list control group (WL).

Method: The sample was comprised of 275 adults smokers (61.4% females, mean age = 45.36, SD = 10.96). After baseline assessment sessions, participants were randomized (ratio: 2.2.1.) to SCBSCT-BA, SCBSCT, or WL. Active groups received 8 weekly 1-hour face-to-face group sessions. Biochemically verified smoking abstinence and depressive symptoms were assessed at the end of treatment, and at 3-, 6-, and 12-month follow-ups.

Results: Significant treatment effects in 7-dayspoint prevalence abstinence rates were found for both active groups at the end of treatment. Abstinence rates at 12-months follow-up were 30% for SCBSCT-BA, and 18% for SCBSCT. Using Multiple Imputation for missing data, regression analysis showed significantly greater ORs for the SCBSCT-BA condition (vs. SCBSCT) at the end of treatment and at 3-months follow-up. At 6-, and 12-months follow-ups, ORs for the SCBSCT-BA condition, although greater, did not reach statistical significance. Multilevel analysis showed that abstinence was related to reductions in depressive symptoms.

Conclusions: SCBSCT-BA obtained positive results at short and medium term. Participants who quit smoking experienced a significant reduction in depressive symptoms. Findings support the benefit of adding BA to a cognitive-behavioral smoking cessation treatment.

Trial registration: www.clinicaltrials.gov NCT02844595.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Behavior*
Cognitive Behavioral Therapy*
Depression / etiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Compliance
Patient Satisfaction
Regression Analysis
Smoking Cessation* / psychology

Associated data

ClinicalTrials.gov/NCT02844595

Grants and funding

This research was supported by the Spanish Ministry of Economy and Competiveness (Project reference: PSI2015-66755-R) and co-financed by FEDER (European Regional Development Fund; pluri-annual plan 2014-2020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.