Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-05T04:18:34.208Z Has data issue: false hasContentIssue false

Persistence targeted smoking cessation for smokers with schizophrenia or schizoaffective disorder: a feasibility study

Published online by Cambridge University Press:  09 July 2020

Marc L. Steinberg*
Affiliation:
Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ08901, USA
Benjamin Billingsley
Affiliation:
Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ08901, USA
Rachel Rosen
Affiliation:
Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ08901, USA
Elizabeth E. Epstein
Affiliation:
Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA01605, USA
Shou-En Lu
Affiliation:
Rutgers School of Public Health, Piscataway, NJ08854, USA
Nicole Weickert
Affiliation:
Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ08901, USA
Jill M. Williams
Affiliation:
Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ08901, USA
*
Author for correspondence: Marc L. Steinberg, E-mail: [email protected]

Abstract

Introduction

Individuals with schizophrenia are more likely to smoke and less likely to quit smoking than those without schizophrenia. Because task persistence is lower in smokers with than without schizophrenia, it is possible that lower levels of task persistence may contribute to greater difficulties in quitting smoking observed among smokers with schizophrenia.

Aims

To develop a feasible and acceptable intervention for smokers with schizophrenia.

Methods

Participants (N = 24) attended eight weekly individual cognitive behavioral therapy sessions for tobacco use disorder with a focus on increasing task persistence and received 10 weeks of nicotine patch.

Results

In total, 93.8% of participants rated the intervention as at least a 6 out of 7 regarding how ‘easy to understand’ it was and 81.3% rated the treatment as at least a 6 out of 7 regarding how helpful it was to them. A total of 62.5% attended at least six of the eight sessions and session attendance was positively related to nicotine dependence and age and negatively related to self-efficacy for quitting.

Discussion

This intervention was feasible and acceptable to smokers with schizophrenia. Future research will examine questions appropriate for later stages of therapy development such as initial efficacy of the intervention and task persistence as a mediator of treatment outcome.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berke, D. S., Kline, N. K., Wachen, J. S., McLean, C. P., Yarvis, J. S., Mintz, J., … Litz, B. T. (2019). Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members. Behaviour Research and Therapy, 118, 717. https://doi.org/10.1016/j.brat.2019.03.003CrossRefGoogle ScholarPubMed
Borrelli, B., Hogan, J. W., Bock, B., Pinto, B., Roberts, M., & Marcus, B. (2002). Predictors of quitting and dropout among women in a clinic-based smoking cessation program. Psychology of Addictive Behaviors, 16(1), 2227. https://doi.org/10.1037/0893-164X.16.1.22CrossRefGoogle Scholar
Brown, R. A., Lejuez, C. W., Kahler, C. W., & Strong, D. R. (2002). Distress tolerance and duration of past smoking cessation attempts. Journal of Abnormal Psychology, 111(1), 180185.CrossRefGoogle ScholarPubMed
Brown, R. A., Reed, K. M. P., Bloom, E. L., Minami, H., Strong, D. R., Lejuez, C. W., … Hayes, S. C. (2013). Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse. Nicotine & Tobacco Research, 15(12), 20052015. https://doi.org/10.1093/ntr/ntt093CrossRefGoogle ScholarPubMed
Brown, R. A., Reed, K. M. P., Bloom, E. L., Minami, H., Strong, D. R., Lejuez, C. W., … Hayes, S. C. (2018). A randomized controlled trial of distress tolerance treatment for smoking cessation. Psychology of Addictive Behaviors, 32(4), 389400. https://doi.org/10.1037/adb0000372CrossRefGoogle ScholarPubMed
Carroll, K. M., & Nuro, K. F. (2006). One size cannot fit all: A stage model for psychotherapy manual development. Clinical Psychology: Science and Practice, 9(4), 396406. https://doi.org/10.1093/clipsy.9.4.396Google Scholar
Cloninger, C. R. (Ed.) (1994). The temperament and character inventory (TCI): A guide to its development and use (1st ed). Washington University: Center for Psychobiology of Personality.Google Scholar
De Leon, J., & Diaz, F. J. (2005). A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophrenia Research, 76(2–3), 135157. https://doi.org/10.1016/j.schres.2005.02.010CrossRefGoogle ScholarPubMed
Derogatis, L. R. (1993). Brief symptoms inventory (BSI): Administration, scoring and procedures manual (3rd ed.). Minneapolis, MN: NCS Pearson, Inc.Google Scholar
Diaz, F. J., James, D., Botts, S., Maw, L., Susce, M. T., & De Leon, J. (2009). Tobacco smoking behaviors in bipolar disorder: A comparison of the general population, schizophrenia, and major depression. Bipolar Disorders, 11(2), 154165. https://doi.org/10.1111/j.1399-5618.2009.00664.xCrossRefGoogle ScholarPubMed
Dickerson, F., Stallings, C. R., Origoni, A. E., Vaughan, C., Khushalani, S., Schroeder, J., & Yolken, R. H. (2013). Cigarette smoking among persons with schizophrenia or bipolar disorder in routine clinical settings, 1999–2011. Psychiatric Services, 64(1), 4450. https://doi.org/10.1176/appi.ps.201200143CrossRefGoogle ScholarPubMed
Dorner, T. E., Trostl, A., Womastek, I., & Groman, E. (2011). Predictors of short-term success in smoking cessation in relation to attendance at a smoking cessation program. Nicotine & Tobacco Research, 13(11), 10681075. https://doi.org/10.1093/ntr/ntr179CrossRefGoogle Scholar
Gard, D. E., Gard, M. G., Kring, A. M., & John, O. P. (2006). Anticipatory and consummatory components of the experience of pleasure: A scale development study. Journal of Research in Personality, 40(6), 10861102. https://doi.org/10.1016/j.jrp.2005.11.001CrossRefGoogle Scholar
Gard, D. E., Kring, A. M., Gard, M. G., Horan, W. P., & Green, M. F. (2007). Anhedonia in schizophrenia: Distinctions between anticipatory and consummatory pleasure. Schizophrenia Research, 93(1–3), 253260. https://doi.org/10.1016/j.schres.2007.03.008CrossRefGoogle ScholarPubMed
Gilbody, S., Peckham, E., Bailey, D., Arundel, C., Heron, P., Crosland, S., … Reilly, J., … Vickers, C. (2019). Smoking cessation for people with severe mental illness (SCIMITAR+): A pragmatic randomised controlled trial. The Lancet Psychiatry, 6(5), 379390. https://doi.org/10.1016/S2215-0366(19)30047-1CrossRefGoogle ScholarPubMed
Graff, F. S., Morgan, T. J., Epstein, E. E., McCrady, B. S., Cook, S. M., Jensen, N. K., & Kelly, S. (2009). Engagement and retention in outpatient alcoholism treatment for women. American Journal on Addictions, 18(4), 277288. https://doi.org/10.1080/10550490902925540CrossRefGoogle ScholarPubMed
Hajek, P., Belcher, M., & Stapleton, J. (1987). Breath-holding endurance as a predictor of success in smoking cessation. Addictive Behaviors, 12(3), 285288.CrossRefGoogle ScholarPubMed
Hartz, S. M., Horton, A. C., Hancock, D. B., Baker, T. B., Caporaso, N. E., Chen, L.-S., … Bierut, L. J. (2018). Genetic correlation between smoking behaviors and schizophrenia. Schizophrenia Research, 194, 8690. https://doi.org/10.1016/j.schres.2017.02.022CrossRefGoogle Scholar
Hartz, S. M., Pato, C. N., Medeiros, H., Cavazos-Rehg, P., Sobell, J. L., Knowles, J. A., … Pato, M. T. (2014). Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry, 71(3), 248. https://doi.org/10.1001/jamapsychiatry.2013.3726CrossRefGoogle ScholarPubMed
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire. British Journal of Addiction, 86(9), 11191127.CrossRefGoogle ScholarPubMed
Kelly, D. L., McMahon, R. P., Wehring, H. J., Liu, F., Mackowick, K. M., Boggs, D. L., … Dixon, L. (2011). Cigarette smoking and mortality risk in people with schizophrenia. Schizophrenia Bulletin, 37(4), 832838. https://doi.org/10.1093/schbul/sbp152CrossRefGoogle ScholarPubMed
Langdon, K. J., Farris, S. G., Hogan, J. B. D., Grover, K. W., & Zvolensky, M. J. (2016). Anxiety sensitivity in relation to quit day dropout among adult daily smokers recruited to participate in a self-guided cessation attempt. Addictive Behaviors, 58, 1215. https://doi.org/10.1016/j.addbeh.2016.02.017CrossRefGoogle Scholar
Leventhal, A. M.. (2010). The Tripartite Pleasure Inventory: A Multidimensional Measure of Anhedonia. Los Angeles, CA: Department of Preventive Medicine and Psychology, University of Southern California.Google Scholar
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin, 136(4), 576600. https://doi.org/10.1037/a0019712CrossRefGoogle ScholarPubMed
Mancino, M., Curran, G., Han, X., Allee, E., Humphreys, K., & Booth, B. M. (2010). Predictors of attrition from a national sample of methadone maintenance patients. The American Journal of Drug and Alcohol Abuse, 36(3), 155160. https://doi.org/10.3109/00952991003736389CrossRefGoogle ScholarPubMed
McGinty, E. E., Zhang, Y., Guallar, E., Ford, D. E., Steinwachs, D., Dixon, L. B., … Daumit, G. L. (2012). Cancer incidence in a sample of Maryland residents with serious mental illness. Psychiatric Services, 63(7), 714717. https://doi.org/10.1176/appi.ps.201100169CrossRefGoogle Scholar
Mercincavage, M., Wileyto, E. P., Saddleson, M. L., Lochbuehler, K., Donny, E. C., & Strasser, A. A. (2017). Attrition during a randomized controlled trial of reduced nicotine content cigarettes as a proxy for understanding acceptability of nicotine product standards: RNC attrition as a proxy of acceptability. Addiction, 112(6), 10951103. https://doi.org/10.1111/add.13766CrossRefGoogle ScholarPubMed
Miller, W. R., & Johnson, W. R. (2008). A natural language screening measure for motivation to change. Addictive Behaviors, 33(9), 11771182. https://doi.org/10.1016/j.addbeh.2008.04.018CrossRefGoogle ScholarPubMed
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.Google Scholar
Postel, M. G., de Haan, H. A., ter Huurne, E. D., van der Palen, J., Becker, E. S., & de Jong, C. A. (2011). Attrition in web-based treatment for problem drinkers. Journal of Medical Internet Research, 13(4), e117. https://doi.org/10.2196/jmir.1811CrossRefGoogle ScholarPubMed
Quinn, E. P., Brandon, T. H., & Copeland, A. L. (1996). Is task persistence related to smoking and substance abuse? The application of learned industriousness theory to addictive behaviors. Experimental and Clinical Psychopharmacology, 4(2), 186190. https://doi.org/10.1037/1064-1297.4.2.186CrossRefGoogle Scholar
Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from stage I. Clinical Psychology: Science and Practice, 8(2), 133142. https://doi.org/10.1093/clipsy.8.2.133.Google Scholar
Simons, J. S., & Gaher, R. M. (2005). The distress tolerance scale: Development and validation of a self-report measure. Motivation and Emotion, 29(2), 83102. https://doi.org/10.1007/s11031-005-7955-3CrossRefGoogle Scholar
Smith, S. S., Piper, M. E., Bolt, D. M., Fiore, M. C., Wetter, D. W., Cinciripini, P. M., & Baker, T. B. (2010). Development of the brief Wisconsin inventory of smoking dependence motives. Nicotine & Tobacco Research, 12(5), 489499. https://doi.org/10.1093/ntr/ntq032CrossRefGoogle ScholarPubMed
Snaith, R. P., Hamilton, M., Morley, S., Humayan, A., Hargreaves, D., & Trigwell, P. (1995). A scale for the assessment of hedonic tone the Snaith–Hamilton pleasure scale. British Journal of Psychiatry, 167(1), 99103. https://doi.org/10.1192/bjp.167.1.99CrossRefGoogle ScholarPubMed
Steinberg, M. L., Billingsley, B., Rosen, R. L., Epstein, E. E., Lu, S.-E., & Williams, J. M. (2020). A novel intervention increases task persistence in smokers with schizophrenia: A proof of concept study. Schizophrenia Research, 215, 453454. https://doi.org/10.1016/j.schres.2019.09.011CrossRefGoogle ScholarPubMed
Steinberg, M. L., Krejci, J. A., Collett, K., Brandon, T. H., Ziedonis, D. M., & Chen, K. (2007). Relationship between self-reported task persistence and history of quitting smoking, plans for quitting smoking, and current smoking status in adolescents. Addictive Behaviors, 32(7), 14511460. https://doi.org/10.1016/j.addbeh.2006.10.008CrossRefGoogle ScholarPubMed
Steinberg, M. L., & Williams, J. M. (2013). State, but not trait, measures of persistence are related to negative affect. Journal of Studies on Alcohol and Drugs, 74(4), 584588. https://doi.org/10.15288/jsad.2013.74.584CrossRefGoogle Scholar
Steinberg, M. L., Williams, J. M., Gandhi, K. K., Foulds, J., & Brandon, T. H. (2010). Lower task persistence in smokers with schizophrenia as compared to non-psychiatric control smokers. Psychology of Addictive Behaviors, 24(4), 724729. https://doi.org/10.1037/a0020972CrossRefGoogle ScholarPubMed
Steinberg, M. L., Williams, J. M., Gandhi, K. K., Foulds, J., Epstein, E. E., & Brandon, T. H. (2012). Task persistence predicts smoking cessation in smokers with and without schizophrenia. Psychology of Addictive Behaviors, 26(4), 850858. https://doi.org/10.1037/a0028375CrossRefGoogle ScholarPubMed
Steinberg, M. L., Williams, J. M., & Li, Y. (2015). Poor mental health and reduced decline in smoking prevalence. American Journal of Preventive Medicine, 49(3), 362369. https://doi.org/10.1016/j.amepre.2015.01.016CrossRefGoogle ScholarPubMed
Strong, D. R., Lejuez, C. W., Daughters, S. B., Marinello, M., & Kahler, C. W. (2003). The computerized mirror tracing task, version 1. Computer Software.Google Scholar
Szatkowski, L., & McNeill, A. (2015). Diverging trends in smoking behaviors according to mental health status. Nicotine & Tobacco Research, 17(3), 356360. https://doi.org/10.1093/ntr/ntu173CrossRefGoogle ScholarPubMed
Tsoi, D. T., Porwal, M., & Webster, A. C. (2013). Interventions for smoking cessation and reduction in individuals with schizophrenia. The Cochrane Database of Systematic Reviews, 2, CD007253CD007253. https://doi.org/10.1002/14651858.CD007253.pub2Google Scholar
Turner, L., Mermelstein, R., Berbaum, M., & Veldhuis, C. (2004). School-based smoking cessation programs for adolescents: What predicts attendance? Nicotine & Tobacco Research, 6(3), 559568. https://doi.org/10.1080/14622200410001696475CrossRefGoogle ScholarPubMed
Williams, J. M., & Hughes, J. R. (2003). Pharmacotherapy: Treatments for tobacco dependence among smokers with mental illness or addiction. Psychiatric Annals, 33(7), 457466.CrossRefGoogle Scholar
Zvolensky, M. J., Feldner, M. T., Eifert, G. H., & Brown, R. A. (2001). Affective style among smokers: Understanding anxiety sensitivity, emotional reactivity, and distress tolerance using biological challenge. Addictive Behaviors, 26(6), 901915. https://doi.org/10.1016/s0306-4603(01)00242-8CrossRefGoogle ScholarPubMed