NCT02538601

Brief Summary

The purpose of this study was to test the efficacy of a CBT-based smoking cessation treatment enhanced with transdiagnostic skills for the management of anxiety and fear-based avoidance behaviors (CBT-A) relative to a standard CBT-based smoking cessation treatment (CBT-S) for smokers with elevated PTSD symptoms who were exposed to the 9/11 World Trade Center disaster. The investigators hypothesized that the CBT-A treatment would yield more favorable outcomes with regard to smoking abstinence as well as improvements in PTSD and respiratory symptoms over a 6-month follow-up period.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Feb 2012

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2012

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2014

Completed
9 months until next milestone

First Submitted

Initial submission to the registry

August 12, 2015

Completed
21 days until next milestone

First Posted

Study publicly available on registry

September 2, 2015

Completed
Last Updated

September 2, 2015

Status Verified

September 1, 2015

Enrollment Period

2.8 years

First QC Date

August 12, 2015

Last Update Submit

September 1, 2015

Conditions

Keywords

Post Traumatic Stress DisorderPTSDCigarette SmokingLower Respiratory SymptomsCognitive Behavioral TherapyCBTTransdiagnostic TreatmentsWorld Trade Center

Outcome Measures

Primary Outcomes (2)

  • Session 8 7-day point prevalence cigarette abstinence

    A dichotomized outcome (yes/no) configured based on biochemically verified 7 day smoking abstinence via Saliva cotinine (cutoff value of 10 ng/ml) and carbon monoxide (CO) analysis of breath samples with a Vitalograph Breathco CO monitor.

    Session 8: on average 2 weeks post-quit day

  • 6-month Follow-up 7-day point prevalence cigarette abstinence

    A dichotomized outcome (yes/no) configured based on biochemically verified 7 day smoking abstinence via Saliva cotinine (cutoff value of 10 ng/ml) and carbon monoxide (CO) analysis of breath samples with a Vitalograph Breathco CO monitor.

    6-month follow-up

Secondary Outcomes (6)

  • Change in WTC related post-traumatic stress disorder (PTSD) symptoms

    Baseline and 2-weeks post-quit attempt

  • 6-month change in WTC related post-traumatic stress disorder (PTSD) symptoms

    Baseline and 6-month follow-up

  • Change in lower respiratory symptoms

    Baseline and 2-weeks post-quit attempt

  • 6-month change in lower respiratory symptoms

    Baseline and 6-month follow-up

  • Change in average daily cigarettes smoked

    Baseline and 2-weeks post-quit attempt

  • +1 more secondary outcomes

Study Arms (2)

CBT-A

EXPERIMENTAL

An 8-session, CBT-based group smoking cessation program (CBT-A) enhanced with transdiagnostic skills for the management of anxiety and fear-based avoidance behaviors.

Behavioral: CBT-A

CBT-S

ACTIVE COMPARATOR

An 8-session, CBT-based, traditional group CBT based smoking cessation program.

Behavioral: CBT-S

Interventions

CBT-ABEHAVIORAL

CBT-A was an 8-session (1.5 hours/session) group treatment for quitting smoking comprised of an optimized protocol that incorporated all elements of the CBT-S treatment plus skills for reducing PTSD/anxiety symptoms and improving tolerance to withdrawal. The CBT-A intervention included skills based on a transdiagnostic approach: (1) repeated interoceptive exposures to feared bodily sensations (e.g., dizziness, racing heart); (2) corrective information about anxiety and cognitive restructuring of catastrophic misinterpretations of somatic sensations (e.g., "I will lose control."); and (3) use of graduated in-vivo exposure to feared and avoided situational experiences related to anxiety, WTC-related PTSD triggers, and smoking (e.g., going to lower Manhattan; driving without smoking).

CBT-A
CBT-SBEHAVIORAL

CBT-S was an adapted group-based CBT smoking cessation treatment delivered in 8 sessions (1.5 hours/session) based on the most recent clinical practice guidelines from the United States Department of Health and Human Services (USDHHS), Treating Tobacco Use and Dependence. Standard cessation elements included psychoeducation on reasons for smoking and barriers to quitting, enlisting social support, monitoring and tapering cigarette use, and counseling regarding high-risk smoking situations and unhelpful ways of thinking about smoking and abstinence. The treatment was similar to protocols used in other smoking cessation research.

CBT-S

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • smoking at least five cigarettes per day
  • reporting interest in smoking cessation treatment
  • direct exposure to the WTC disaster (e.g., responding to the event or witnessing the event in person)
  • scoring \>30 on the Posttraumatic Stress Disorder Checklist

You may not qualify if:

  • current participation in another smoking cessation treatment
  • alcohol dependence within the last six months
  • serious mental illness (e.g., psychosis, mania)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Stony Brook University, Putnam Hall

Stony Brook, New York, 11794, United States

Location

Related Publications (1)

  • Waszczuk MA, Li X, Bromet EJ, Gonzalez A, Zvolensky MJ, Ruggero C, Luft BJ, Kotov R. Pathway from PTSD to respiratory health: Longitudinal evidence from a psychosocial intervention. Health Psychol. 2017 May;36(5):429-437. doi: 10.1037/hea0000472. Epub 2017 Mar 9.

MeSH Terms

Conditions

Cigarette SmokingStress Disorders, Post-TraumaticSigns and Symptoms, Respiratory

Condition Hierarchy (Ancestors)

Tobacco SmokingSmokingBehaviorTobacco UseStress Disorders, TraumaticTrauma and Stressor Related DisordersMental DisordersSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Roman Kotov, PhD

    Stony Brook University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 12, 2015

First Posted

September 2, 2015

Study Start

February 1, 2012

Primary Completion

November 1, 2014

Study Completion

November 1, 2014

Last Updated

September 2, 2015

Record last verified: 2015-09

Locations