UH receives NIDA grant to study transdiagnostic CBT to address tobacco cessation

3-year study involves 60 smokers with anxiety, ages 18-65, willing to attempt quitting in 30 days

According to the Centers for Disease Control and Prevention, tobacco use continues to be the leading preventable cause of death in the U.S. resulting in more than 440,000 premature deaths a year. An additional 25 million smokers will most likely die of a smoking related illness.

To address this problem and further research in the area, the National Institute on Drug Abuse (NIDA) awarded a $675,000 grant to Michael J. Zvolensky, the Hugh Roy and Lillie Cranz Distinguished University Professor in the department of clinical psychology at the University of Houston (UH) and Peter J. Norton, associate professor of psychology at UH. Zvolensky and Norton will serve as co-principal investigators "Augmenting Smoking Cessation with Transdiagnostic Cognitive Behavior Therapy (CBT) for Smokers with Anxiety," a study that will examine whether a "transdiagnostic" cognitive behavior therapy (CBT), a model that allows therapists to apply one set of principles across anxiety disorders, can improve smoking cessation for anxious smokers.

"Despite interventions like nicotine replacement therapy and national advertising campaigns on the consequences of smoking, people in the smoking cessation and addiction field noticed the rates of tobacco use had stabilized, but the rates of tobacco addiction weren't any different than they were 20 years ago. We had treated all the easy people. Those left were the complicated cases with something else going on," said Zvolensky.

"What we know from our research is that people who smoke often have anxiety and other mental disorders and vice versa. Existing treatment plans for smoking cessation have not addressed anxiety and stress disorders in any formal and meaningful way."

Norton notes one of the biggest problems in helping anxious people quit smoking is that many people smoke cigarettes to calm their anxiety or reduce stress. By combining an evidence-based anxiety disorder treatment and smoking cessation program, Norton and Zvolensky expect to be able to help people quit, and stay quit, by reducing their anxiety, one of the biggest barriers to quitting smoking.

Participants are needed for the study. The treatment-based research follows 60 adults, ages 18-65, with anxiety disorders who are smokers of at least 10 cigarettes a day. Participants must have smoked for a year or more and willing to make an attempt to quit within 30 days of the start of the study. The study involves a telephone pre-screen and a baseline appointment. During the baseline appointment, participants will complete an interview, and if eligible, receive free nicotine replacement therapy. They will meet with therapists for 11-weeks to decrease anxiety and receive help through the cessation experience.

"The significance of this research is developing an effective smoking cessation treatment that targets people with anxiety disorders, so they will be smoke-free," said Zvolensky. "The second goal is reducing the amount of use, also known as harm reduction. You don't have to view things as complete abstinence to be successful. That's important in the case of tobacco, in particular, because even simple reductions from 20 to 10 or from 10 to five cigarettes a day could have a linear decrease in exposure to a lot of other negative outcomes."

A prominent researcher in health behaviors, Zvolensky has published more than 300 peer-reviewed articles and co-edited two books, "Distress Tolerance: Theory, Research and Clinical Applications" and "Anxiety in Health Behaviors and Physical Illness." He has been cited extensively for his research on the relationship between anxiety and addiction.