Cancer Control Research5R01CA156241-02
Kahler, Christopher W.
DEVELOPMENT OF POSITIVE PSYCHOTHERAPY FOR SMOKING CESSATION
DESCRIPTION (provided by applicant): Mood disturbance has been linked consistently to poor smoking cessation outcomes and therefore may be an important target for intervention in smoking cessation treatment. However, smoking cessation programs incorporating cognitive behavioral therapy for depression or mood management interventions, which primarily focus on negative mood and depressive symptoms, have not proven effective for the majority of smokers and do not appear to improve mood during or after smoking cessation. Given these findings, combined with additional data indicating that low positive mood may impede smoking cessation, an alternative approach to enhancing moods during smoking cessation is still needed. Positive psychotherapy (PPT) offers a new and innovative alternative to traditional cognitive behavioral therapy for depression and has been found to yield rapid and meaningful increases in happiness and positive affect and decreases in depressive symptoms. Rooted in the field of positive psychology, PPT and related interventions focus on sources of individual strength and on enhancing well-being and positive emotions rather than focusing on deficits and negative emotion. Such an approach may be ideal for smoking cessation, allowing participants to increase their experience of positive emotions, build psychological and social resources for coping with stress, and develop less cynical and hostile cognitions, all of which may lead to better smoking outcomes. Furthermore, the focus of PPT on well-being, as opposed to depressive symptoms, may increase its breadth of appeal to smokers and encourage greater engagement with treatment. The primary objectives of this project are to develop a manualized adaptation of PPT for smoking cessation (PPT-S) and to obtain an effect size estimate for this intervention compared to standard smoking cessation treatment among smokers with low levels of positive affect. Potential mediators of treatment effects also will be examined. The project will take place in two phases. During the first phase (Stage 1a of treatment development), investigators will finalize the PPT-S manual and pilot it with 15 low positive affect smokers. In the second phase (Stage 1b), investigators will conduct a preliminary randomized clinical trial (N = 60) to examine the feasibility, acceptability, and efficacy of PPT-S over 26 weeks of follow up in comparison to a standard smoking cessation treatment. Both treatments will be delivered in individual six sessions over six weeks, and will include provision of transdermal nicotine patch. The effect size estimates from this Stage 1b research will provide the foundation for a future application to conduct a large-scale, Stage II, randomized clinical trial. This project represents a significant and innovative application of the burgeoning field of positive psychology to the field of addictions treatment, a cross-fertilization that could substantially enrich addictions research and theory. Ultimately, the investigators expect that this program of research could result in a well-specified, efficacious intervention that could be readily disseminated and be applicable to a broad range of smokers seeking cessation treatment. PUBLIC HEALTH RELEVANCE: This project seeks to develop a smoking cessation treatment that incorporates central elements of Positive Psychotherapy, a treatment approach that is rooted in the field of positive psychology and that focuses on enhancing well-being and positive emotions and on building upon personal strengths. The project will provide a preliminary test of the ability of this newly developed treatment to increase rates of smoking abstinence and to improve moods during smoking cessation in comparison to a traditional smoking cessation treatment program. If effective, such a treatment approach could be readily applied in smoking cessation treatment programs and could significantly improve public health by increasing rates of smoking cessation.