Newer Form of CBT More Effective for Smoking Cessation

Article excerpt

FROM THE AMERICAN PSYCHIATRIC ASSOCIATION'S INSTITUTE ON PSYCHIATRIC SERVICES

SAN FRANCISCO - Substance expectation therapy, a newer form of cognitive-behavioral therapy, appears to do a better job helping people quit smoking, and it's less of a burden on therapists.

Among 20 smokers randomized to substance expectation therapy (SET), 75% (15) completed all 12 weekly, hour-long sessions, and SET participants had a mean carbon monoxide breath concentration during the last 3 of 11 ppm.

The 20 randomized to more traditional cognitive-behavioral therapy (CBT) didn't do as well. Just 45% (nine) completed the 12 weeks, and participants had a mean carbon monoxide breath concentration of 18 ppm during the last few sessions. The results were presented at the meeting.

The differences were statistically significant, and may have something to do with the looser, more free-form format of SET therapy.

There s much less indirect finger-wagging; there might be a little homework, but if they don't complete it, that's okay. Whereas within the CBT model, when you give a homework assignment, a lot of times people don't show up the next week," said lead investigator Charles H. Wilber, assistant director of the Brace-land Center for Mental Health and Aging, Hartford, Conn., and a senior scientist at the Burlingame Center for Psychiatric Research and Education at Hartford Hospital.

Developed over the last 15 years by Mr. Wilber and his colleagues at the hospital, Adam Jaffe, Ph.D., SET has proven successful in helping people quit hard drugs.

This is the first time it's been shown to help smokers, too.

Like CBT, SET addresses triggers, but the main emphasis is on shifting the positive expectations clients have about lighting up to negative expectations. It's a less linear approach than traditional CBT.

In the early sessions, patients are made aware of what they expect from smoking, often relaxation and better focus. …