Web-Based Acceptance and Commitment Therapy Smoking Cessation Treatment for Smokers With Depressive Symptoms
Open accessAbstract
OBJECTIVE: Smokers with depressive symptoms have more difficulty quitting smoking than the general population of smokers. The present study examines a web-based treatment using acceptance and commitment therapy (ACT) for smokers with depressive symptoms. The study aimed to determine participant receptivity to the intervention and its effects on smoking cessation, acceptance of internal cues, and depressive symptoms. METHODS: Smokers who had positive screening results for depressive symptoms at baseline (n = 94) were selected from a randomized controlled trial (N = 222) comparing web-based ACT for smoking cessation (WebQuit.org) with Smokefree.gov. Forty-five participants (48%) completed the three-month follow-up. RESULTS: Compared to Smokefree.gov, WebQuit participants spent significantly more time on site (p =.001) and had higher acceptance of physical cravings (p =.033). While not significant, WebQuit participants were more engaged and satisfied with their program and were more accepting of internal cues overall. There was preliminary evidence that WebQuit participants had higher quit rates (20% versus 12%) and lower depressive symptoms at follow-up (45% versus 56%) than those in Smokefree.gov. CONCLUSIONS: This was the first study of web-based ACT for smoking cessation among smokers with depressive symptoms, with promising evidence of receptivity, efficacy, impact on a theory-based change process, and possible secondary effects on depression. A fully powered trial of the ACT WebQuit.org intervention specifically for depressed smokers is needed. This was part of a clinical trial registered as NCT#01166334 at www.clinicaltrials.gov .
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Five interventions were primarily designed to manage and reduce depression and depressive symptoms.
“Five interventions were primarily designed to manage and reduce depression and depressive symptoms [36,45,46,51,52]”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
The Methods (Interventions) state that WebQuit.org was designed for smoking cessation in the general population and contained no interventions specifically targeting depressive symptoms. The Discussion likewise says it had no elements focusing on depression. This contradicts the description of this intervention as primarily designed to manage or reduce depressive symptoms. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredReview of RCTs focused on depression as the primary outcome revealed that ACT was more effective than control, where control was either WLC or an active control.
“Review of those RCTs focused on depression as the primary outcome [36,45,46,49,51] revealed that ACT was more effective than control, where control was either WLC or an active control.”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
The Results (page unavailable) report fewer participants screening positive for depression after ACT than after the active comparator, Smokefree.gov (45% versus 56%), but the difference was not statistically significant (p = .66). The Discussion describes depression as a possible secondary effect of this smoking-cessation study, not its primary outcome; the paper therefore does not establish that ACT was more effective for depression. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThree interventions were automated, and the remainder were guided.
“A total of 3 interventions were automated, that is, no guide or coach was involved in the delivery of the therapeutic program [36,47,48] and the remainder were guided interventions”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
Six RCTs reported a measure of participant satisfaction, of which 2 focused on system usability.
“Six RCTs reported a measure of participant satisfaction, of which, 2 focused on system usability [36,45-48,50].”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
None of the interventions specifically targeted quality of life and 2 did not include an outcome measure that could be included in the meta-analysis calculation.
“However, as with anxiety, none of the interventions specifically targeted quality of life and 2 did not include an outcome measure that could be included in the meta-analysis calculation [36,47].”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
Of the 10 included studies, 4 (40%) were judged low risk of bias, 1 (10%) high risk, and 5 (50%) unclear risk.
“Of the 10 studies included, 4 (40%) were judged to be of low risk of bias [29,46,49,52], one (10%) of high risk [36], and an unclear risk of bias was assigned to 5 (50%) [45,47,48,50,51] of the included studies.”
From Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis. (2016) · cites this paper as [36]
The Methods (Participants) describe one randomized smoking-cessation study, and the Discussion describes its limitations. Our copy does not report a review of ten studies or the stated low-, high-, and unclear-risk counts (searched: risk of bias, low risk, high risk, and unclear risk). Those counts appear to be the citing authors’ assessment rather than a finding reported by this source. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Jones, H. A., Heffner, J. L., Mercer, L., Wyszynski, C. M., Vilardaga, R., & Bricker, J. B.
- Affiliations
- Fred Hutch Cancer Center (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Bricker, Jonathan B.
- Venue
- Journal of Dual Diagnosis
- Publisher
- Informa UK Limited
- Published
- 2015-01-02
- Volume
- 11
- Issue
- 1
- Pages
- 56-62
- ISSN
- 1550-4263 (ISSN-L)
- 1550-4271
- PMC
- PMC4325367
- OpenAlex
- W1965549999
- Semantic Scholar
- d95b9abe38b0d3b8a127c7e68d34106e53e5d297
- Cited by
- 30
- References
- 26
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 1
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Dual Diagnosis (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (T32MH082709)
- National Institute on Drug Abuse (K99DA037276, K23DA026517)
- National Cancer Institute (R01CA151251, R01CA166646)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD007543, R24HD042828)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- acceptance and commitment therapy, smoking cessation, depressive symptoms, online intervention, nicotine craving, intervention engagement, dual diagnosis, quit rates
- MeSH terms
- Adult, Depression, Female, Humans, Male, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Internet, Acceptance and Commitment Therapy
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