NCT03413423

Brief Summary

Summary of the Project : Quitting smoking following acute coronary syndrome (ACS) can reduce mortality up to 50%. However, depression and smoking are highly co-morbid and depressed mood may interfere with cessation and independently predicts mortality. Thus, a single, integrated treatment for both smoking and depression could be highly effective in reducing post-acute coronary syndrome mortality. Behavioral Activation (BA) is a well established treatment for depression and has recently shown promise as a treatment for smoking cessation. The investigators systematically developed an intervention integrating gold standard smoking cessation counseling with existing BA based mood management techniques for post-ACS smokers; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). Objective: For this R01 the investigators will evaluate the efficacy of using a single, integrated treatment that targets both depressed mood and smoking (BAT-CS).

Trial Health

75
On Track

Trial Health Score

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

Enrollment
233

participants targeted

Target at P75+ for not_applicable

Timeline
0mo left

Started Jan 2018

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
active not recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress99%
Jan 2018May 2026

First Submitted

Initial submission to the registry

January 19, 2018

Completed
10 days until next milestone

First Posted

Study publicly available on registry

January 29, 2018

Completed
Same day until next milestone

Study Start

First participant enrolled

January 29, 2018

Completed
6.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 8, 2024

Completed
2.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 30, 2026

Expected
Last Updated

September 15, 2025

Status Verified

September 1, 2025

Enrollment Period

6.3 years

First QC Date

January 19, 2018

Last Update Submit

September 9, 2025

Conditions

Keywords

smokingdepressionBehavioral ActivationMood managementSecondary Prevention

Outcome Measures

Primary Outcomes (2)

  • 7-day point prevalence abstinence from smoking

    Self-report of no smoking, not even a puff, for 7 days; then Bio-chemically confirmed with saliva cotinine or by carbon monoxide in a breath sample

    12 Months

  • Depression Symptoms

    The 9 item Patient Health Questionnaire (PHQ-9) ranges from 0-27 with higher scores indicating higher depression symptoms.

    12 Months

Secondary Outcomes (11)

  • Continuous Abstinence From Smoking Since Hospital Discharge

    12 Months

  • Time to Smoking Relapse

    12 Months

  • Time to Smoking Lapse

    12 Months

  • Depressed mood

    The 10 item Center for Epidemiologic Studies Depression Scale ranges from 0-30 with higher scores indicating higher depression symptoms.

  • Positive Affect

    12 Months

  • +6 more secondary outcomes

Study Arms (2)

BAT-CS

EXPERIMENTAL

Participants will receive standard smoking cessation plus Behavioral Activation based mood management. Will be offered the nicotine patch if medically cleared.

Behavioral: BAT-CS

Smoking Cessation and Health & Wellness

ACTIVE COMPARATOR

Participants will receive standard smoking cessation plus health and wellness education. Will be offered the nicotine patch if medically cleared.

Behavioral: Smoking Cessation and Health & Wellness

Interventions

BAT-CSBEHAVIORAL

All participants will receive one hour standard smoking cessation counseling during their hospitalization for an acute coronary syndrome. Participants will be randomized 1 week after discharge. Those assigned to BAT-CS condition will receive 5 more counseling sessions over the 12 weeks after discharge. The first will be up to one hour and will be conducted in person. The next 4 sessions will occur by phone and will take about 30 minutes. Post-discharge sessions will be focused on smoking cessation and mood management using behavioral activation techniques. Participants will be offered the nicotine patch if medically cleared.

Also known as: Smoking Cessation and Mood Management
BAT-CS

All participants will receive one hour of standard smoking cessation counseling during their hospitalization for an acute coronary syndrome. Participants will be randomized 1 week after discharge. Those assigned to the Smoking Cessation plus Health and Wellness condition will receive 5 more counseling sessions over the 12 weeks after hospital discharge. The first will be up to one hour and will be conducted in person. The next 4 sessions will occur over the phone and will take about 30 minutes. Post-discharge sessions will be focused on smoking cessation and didactic health and wellness education. Participants will be offered the nicotine patch if medically cleared.

Smoking Cessation and Health & Wellness

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • hospital inpatients with an ACS diagnosis documented in medical record within the past 30 days
  • smoked equal or greater than 1 cigarette per day before being hospitalized
  • age of 18-75 years
  • English fluency
  • willing to consider quitting smoking at discharge
  • has a telephone or is willing to use a study issued cell phone
  • willing to consent to all study procedures.

You may not qualify if:

  • limited mental competency
  • presence of severe mental illness that would interfere with participation or suicidality
  • expected discharge to hospice or greater than 50% chance of 6 month mortality per risk calculator
  • currently attending counseling for depression or smoking cessation.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hennepin County Medical Center

Minneapolis, Minnesota, 55415, United States

Location

Related Publications (1)

  • Adkins-Hempel M, Japuntich SJ, Chrastek M, Dunsiger S, Breault CE, Ayenew W, Everson-Rose SA, Nijjar PS, Bock BC, Wu WC, Miedema MD, Carlson BM, Busch AM. Integrated smoking cessation and mood management following acute coronary syndrome: Protocol for the post-acute cardiac event smoking (PACES) trial. Addict Sci Clin Pract. 2023 May 12;18(1):29. doi: 10.1186/s13722-023-00388-9.

    PMID: 37173792BACKGROUND

Related Links

MeSH Terms

Conditions

Acute Coronary SyndromeTobacco UseSmokingDepression

Interventions

Health

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesBehaviorBehavioral Symptoms

Intervention Hierarchy (Ancestors)

Population Characteristics

Study Officials

  • Andrew Busch, PhD

    Senior Investigator

    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
PRINCIPAL INVESTIGATOR
PI Title
Senior Investigator

Study Record Dates

First Submitted

January 19, 2018

First Posted

January 29, 2018

Study Start

January 29, 2018

Primary Completion

May 8, 2024

Study Completion (Estimated)

May 30, 2026

Last Updated

September 15, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will not share

Completely de-identified data (i.e.,data that has been cleaned of all 18 types of HIPAA identifiers) will be available to other qualified researchers. Within 18 months of study completion, we will make datasets available to interested investigators who submit a written request to the PI. The only contingency on the use of the data will be that ethical guidelines be followed (e.g., only individuals who have completed a research ethics training course will have access to the data, the data will be stored securely). The NIH will be notified of transmissions of the data to interested investigators.

Locations