Effect of cognitive behavioral therapy on smokers' cognitive coping skills

Although nearly 70% of smokers in the United States have tried to abstain form smoking, less than 5% who attempt to quit on their own successfully maintain abstinence. Depressed smokers are thought to have an even harder time quitting. To meet these smokers' needs, researchers have begun designing cognitive behavioral smoking cessation treatments. These treatments are designed to reduce dysphoria-related smoking and thus improve the likelihood of abstinence. These studies have yielded mixed results. In an effort to better understand these mixed findings, the current study was designed to test the effects of cognitive therapy on smokers' cognitive coping skills. Fifty-one smokers were randomized to either a comparison group, which included standard cessation education, behavioral strategies, and scheduled, reduced smoking, or a cognitive behavioral treatment group (CBT), which included the elements of the comparison group as well as cognitive therapy. Both groups consisted of eight 90-minute sessions. In the CBT condition, smokers also learned to manage negative affect through cognitive restructuring. Contrary to expectations, CBT did not improve smokers' cognitive coping skills. That is, smokers in the CBT group did not show greater improvement in their cognitive coping skills from pre-test to post-test than comparison group participants. The alternative hypothesis predicted that CBT would reduce dichotomous thinking, but this finding failed to reach traditional levels of significance. In an exploratory vein, the two hypotheses were investigated among smokers presumed to be more vulnerable to depression. In contrast to what other studies have found, CBT improved cognitive coping skills only among smokers without a history of depression. Thirty-eight percent of CBT participants and 22% of comparison group participants were abstinent one month after quit date.