Research shows that people with PTSD are more likely to smoke than people without PTSD. It also shows that people with PTSD have more difficulty at attempts to quit smoking. This study is part of a program aimed at finding out how best to help smokers quit who also have PTSD.
One option is to give patients standard smoking-cessation treatment, including nicotine replacement and cognitive-behavioral therapy. Another is to give patients the standard smoking-cessation treatment in addition to treatment for their PTSD symptoms (called prolonged exposure). However, it is not known which method works better. In order to answer this question, patients will be assigned by chance to one of two groups. One group will be given standard smoking-cessation treatment to help quit smoking. A second group will be given the standard smoking-cessation intervention to help quit smoking in addition to a form of psychotherapy called prolonged exposure to reduce symptoms of PTSD.
The patients will be randomly assigned (by chance) to one of these groups. If the patient is assigned to the smoking-cessation only condition and still has PTSD symptoms after the last study visit (week 30) the patient will be offered treatment for his or her PTSD symptoms (prolonged exposure) at no cost. The patient's participation will help the investigators determine if treating PTSD symptoms enhances the ability of standard smoking cessation to help people quit smoking.
- Male and female patients ages 18 to 65 capable of providing informed consent
- Willing and able to provide informed consent, attend all study visits and comply with the protocol
- Daily smoker for at least 3 months
- Currently smoke an average of at least 8 cigarettes per day
- Report a motivation to quit smoking in the next month of at least 5 on a 10-point scale
- Meet criteria for current diagnosis of PTSD via structured clinical interview
- Current diagnosis of a psychotic, eating, developmental, or bipolar disorder
- Significant suicide risk as determined by structured interview
- Psychoactive substance abuse or dependence (excluding nicotine dependence) within the past 6 months
- Limited mental competency and the inability to give informed, voluntary, written consent to participate
- Current use of any pharmacotherapy or psychotherapy for smoking cessation not provided by the researchers during the quit attempt
- Current psychotherapy directed specifically toward treatment of PTSD
- Use of other tobacco products
- Planning on moving (outside of the immediate area) in the next 6 months
- Insufficient command of the English language (i.e., cannot carry on a conversation with an interviewer in English or read associated text)