UW-CTRI Study: Smokers With a History of Psychiatric Disorders Show Poorer Response to Counseling

Intensive counseling with smokers that have psychiatric histories may not lead to higher abstinence rates, according to a new paper by UW-CTRI researchers.

Whereas the original outcome paper, published in Addiction, supports the combined use of pre-quit nicotine gum and intensive in-person counseling in all smokers, the current paper sheds light on how multiple intervention components work among different groups of smokers, according to UW-CTRI researcher Dr. Megan Piper, the lead author of two related papers published in Drug and Alcohol Dependence.

The paper is part of a series looking at smoking-cessation treatment. Researchers used factorial designs to evaluate six discrete quit-smoking intervention components, their presumed mechanisms, and how well each component works for different groups of smokers. Factorial designs allow researchers to analyze multiple discrete components at the same time, according to Piper.

“With factorial designs, we can know what these components do, and find out if they work for all smokers,” Piper said. “We found that there was an opposite effect of what we thought would happen clinically, with psychiatric patients not responding well to intensive in-person counseling.”

Heavier smokers also showed a poorer response to counseling interventions than light smokers did.

Factors such as race, gender and education did not affect the six intervention components in terms of abstinence rates.

The vast majority of participants with psychiatric history reported depression or anxiety disorders. Piper said it is vital to understand more fully how psychiatric history can influence response to smoking-cessation interventions.