Showing papers by "Richard A. Brown published in 2009"

A prospective examination of distress tolerance and early smoking lapse in adult self-quitters

Abstract: Introduction A significant percentage of smokers attempting cessation lapse to smoking within a matter of days, and current models of relapse devote insufficient attention to such early smoking lapse. Studies attempting to relate severity of nicotine withdrawal symptoms to short-term smoking cessation outcomes have yielded equivocal results. How one reacts to the discomfort of nicotine withdrawal and quitting smoking (i.e., distress tolerance) may be a more promising avenue of investigation with important treatment implications. Methods The present investigation examined distress tolerance and early smoking lapse using a prospective design. Participants were 81 adult daily smokers recruited through newspaper advertisements targeted at smokers planning to quit smoking without assistance (i.e., no pharmacotherapy or psychosocial treatment; 42 males and 39 females; mean age = 42.6 years, SD = 12.20). Results As hypothesized, both greater breath-holding duration and carbon dioxide-enriched air persistence were associated with a significantly lower risk of smoking lapse following an unaided quit attempt. These effects were above and beyond the risk associated with levels of nicotine dependence, education, and history of major depressive disorder, suggesting that distress tolerance and task persistence may operate independently of risk factors such as nicotine dependence and depressive history. In contrast to expectation, persistence on the Paced Auditory Serial Addition Test (a psychological challenge task) was not a significant predictor of earlier smoking lapse. Discussion These results are discussed in relation to refining theoretical models of the role of distress tolerance in early smoking lapse and the utility of such models in the development of specialized treatment approaches for smoking cessation.

Aerobic Exercise for Alcohol Recovery: Rationale, Program Description, and Preliminary Findings.

Abstract: Alcohol use disorders are a major public health concern. Despite the demonstrated efficacy of a number of different treatments for alcohol dependence, relapse remains a major problem. Healthy lifestyle changes may contribute to long-term maintenance of recovery, and interventions targeting physical activity, in particular, may be especially valuable as an adjunct to alcohol treatment. In this article, the authors discuss the rationale and review potential mechanisms of action whereby exercise might benefit alcohol dependent patients in recovery. They then describe the development of a 12-week moderate-intensity aerobic exercise program as an adjunctive intervention for alcohol dependent patients in recovery. Preliminary data from a pilot study (N = 19) are presented, and the overall significance of this research effort is discussed.

Impact of bupropion and cognitive-behavioral treatment for depression on positive affect, negative affect, and urges to smoke during cessation treatment.

Abstract: Introduction: Bupropion and cognitive–behavioral treatment (CBT) for depression have been used as components of treatments designed to alleviate affective disturbance during smoking cessation. Studies of treatment-related changes in precessation affect or urges to smoke are needed to evaluate the proposed mechanisms of these treatments.

Health risk behaviors in relation to making a smoking quit attempt among adolescents

Abstract: The primary aim of this study was to examine youth risk behaviors in relation to: (a) making a smoking quit attempt, and (b) successful cessation among adolescent smokers. Data were analyzed from the public use dataset of the 2003 national school-based Youth Risk Behavior Survey. The sample consisted of 2,033 students (weighted mean age of 16.3 years, 49.8% female, 73.6% White) who reported a history of daily smoking. While almost two-thirds (63.5%) of adolescent smokers reported making a quit attempt in the last year, only 10% of those were able to successfully quit. Factors associated with making a quit attempt included depression and participating in sports while high-risk sexual activity and engaging in substance use other than alcohol or marijuana were negatively related to making a quit attempt. Externalizing health behaviors (e.g., fighting, drug use, and high risk sexual activity) were associated with decreased likelihood of cessation. Findings from this study may inform efforts to develop more effective smoking prevention and treatment programs for youth.

Hostility and smoking cessation treatment outcome in heavy social drinkers.

Abstract: Hostility is a multifaceted construct encompassing affective, behavioral, and cognitive aspects. There is preliminary evidence linking hostility to poorer outcomes in smoking cessation treatment; however, it is unclear which components of hostility are most important in cessation. In this study, we examined multiple aspects of trait hostility in 92 heavy social drinkers who were seeking smoking cessation treatment. Consistent with our hypothesis, we found that the cognitive component of hostility was most relevant to smoking cessation outcome. Specifically, those who expressed bitterness about their life and tended to believe that they had poor luck and had gotten a raw deal out of life had poor smoking cessation outcomes. Cognitive measures of hostility also predicted greater nicotine withdrawal symptoms one week after quitting smoking. Other components of hostility including anger and both physical and verbal aggression did not significantly predict smoking outcome or nicotine withdrawal. Further examination of how a hostile world view contributes to smoking cessation failure is warranted as this facet of hostility may prove a valuable target for smoking cessation interventions.

Smoking Characteristics of Adolescent Smokers With Post-traumatic Stress Disorder in a Psychiatric Inpatient Setting

Abstract: Although there has been a gradual decline in adolescent smoking since the late 1990s, it continues to be a significant public health concern. Among adults, post-traumatic stress disorder (PTSD) seems to be a significant risk factor for increased smoking. This study examined smoking-related characteristics of adolescent smokers with and without PTSD receiving inpatient psychiatric services. In this study, we conducted structured clinical interviews with 191 adolescents (aged 13 to 17 years) who were hospitalized in an inpatient psychiatric facility. Results suggested that adolescent smokers with PTSD had higher nicotine dependence severity scores but were not more likely to meet criteria for nicotine dependence compared with those without PTSD. Future directions are discussed.