Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse

Brown, R. A.; Reed, K. M. P.; Bloom, E. L.; Minami, H.; Strong, D. R.; Lejuez, C. W.; Kahler, C. W.; Zvolensky, M. J.; Gifford, E. V.; Hayes, S. C.

doi:10.1093/ntr/ntt093

Cited by 81Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesMindfulness and Compassion Interventions

Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse

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Brown, R. A., Reed, K. M. P., Bloom, E. L., Minami, H., Strong, D. R., Lejuez, C. W., Kahler, C. W., Zvolensky, M. J. +2 more·2013·Nicotine & Tobacco Research

DOI 10.1093/ntr/ntt093PMC PMC3819975

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Abstract

INTRODUCTION: An inability to tolerate distress is a significant predictor of early smoking lapse following a cessation attempt. We conducted a preliminary randomized controlled trial to compare a distress tolerance (DT) treatment that incorporated elements of exposure-based therapies and Acceptance and Commitment Therapy to standard smoking cessation treatment (ST). METHODS: Smokers with a history of early lapse in prior quit attempts received either DT (N = 27; 9 2-hr group and 6 50-min individual sessions) or ST (N = 22; 6 90-min group and 1 20-min individual session), plus 8 weeks of transdermal nicotine patch. RESULTS: At the end of behavioral treatment, odds of abstinence among participants receiving DT were 6.46 times greater than among participants receiving ST (66.7% vs. 31.8%), equivalent to a medium- to large-effect size. Odds of abstinence for DT were still 1.73 times greater at 8 weeks, corresponding to a small- to medium-effect size, although neither this difference nor those at 13 and 26 weeks were statistically significant. Furthermore, of those who lapsed to smoking during the first week postquit, DT participants had more than 4 times greater odds of abstinence than ST participants at the end of treatment. Relative to ST, DT participants also reported a larger decrease in experiential avoidance, a hypothesized DT treatment mediator, prior to quit day. The trajectory of negative mood and withdrawal symptoms in DT differed from ST and was largely consistent with hypotheses. CONCLUSIONS: Reasons for the decrease in abstinence in DT after treatment discontinuation and suggestions for future research are discussed.

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Brown 2013 observed no statistically significant or clinically meaningful difference between conditions for negative affect at four weeks post-quit.
“Brown 2013 (49 participants) analysed negative affect at four weeks post‐quit and observed no statistically significant or clinically meaningful difference between conditions.”
From Mindfulness for smoking cessation (2022) · cites this paper as Brown 2013
Complete-case analysis for Brown 2013 did not substantially change the interpretation of the result (RR 1.68, 95% CI 0.34 to 8.28; 46 participants).
“Using complete‐case analysis did not substantially change the interpretation of the result (RR 1.68, 95% CI 0.34 to 8.28; 46 participants; Analysis 6.10).”
From Mindfulness for smoking cessation (2022) · cites this paper as Brown 2013
Brown 2013's comparison of distress tolerance training with less intensive treatment had substantial imprecision (RR 1.63, 95% CI 0.33 to 8.08; 49 participants; low-certainty evidence).
“There was substantial imprecision, meaning the result could indicate potential harm as well as considerable benefit (RR 1.63, 95% CI 0.33 to 8.08; 49 participants; low‐certainty evidence; Analysis 3.2).”
From Mindfulness for smoking cessation (2022) · cites this paper as Brown 2013

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A randomized controlled trial of distress tolerance treatment for smoking cessation.
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Distress Tolerance Treatment for Early-Lapse Smokers: Rationale, Program Description, and Preliminary Findings
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Distress tolerance and early smoking lapse
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A prospective examination of distress tolerance and early smoking lapse in adult self-quitters
Brown, R. A., Lejuez, C. W., Strong, D. R., Kahler, C. W., Zvolensky, M. J., Carpenter, L. L., Niaura, R., & Price, L. H. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp041 · Cited by 158 · see citing works
Multi-Method Assessment of Distress Tolerance and Smoking-Related Factors among Adult Daily Smokers
Mathew, A., Heckman, B., Froeliger, B., Saladin, M., Brown, R. A., Hitsman, B., & Carpenter, M. (2018) · Experimental and clinical psychopharmacology · doi:10.1037/pha0000238 · Cited by 8 · see citing works

Authors: Brown, R. A., Reed, K. M. P., Bloom, E. L., Minami, H., Strong, D. R., Lejuez, C. W., Kahler, C. W., Zvolensky, M. J., Gifford, E. V., & Hayes, S. C.
Affiliations: Brown University (US)
Clark University (US)
University of California San Diego (US)
University of Maryland, College Park (US)
University of Houston (US)
VA Palo Alto Health Care System (US)
University of Nevada, Reno (US)
ORCID: Brown, R. A.
Reed, K. M. P.
Bloom, E. L.
Minami, H.
Strong, D. R.
Lejuez, C. W.
Kahler, C. W.
Zvolensky, M. J.
Hayes, S. C.
Venue: Nicotine & Tobacco Research
Publisher: Oxford University Press (OUP)
Published: 2013-07-24
Volume: 15
Issue: 12
Pages: 2005-2015
ISSN: 1462-2203 (ISSN-L)
1469-994X
DOI: 10.1093/ntr/ntt093
PMC: PMC3819975
OpenAlex: W2101168653
Cited by: 81
References: 44
Citations by year: 2025: 5 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 7 · 2018: 14 · 2017: 3 · 2016: 13 · 2015: 7 · 2014: 8 · 2013: 1
FWCI: 6.72
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Nicotine & Tobacco Research (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: National Institute on Drug Abuse (DA017332, R01DA017332)
Topics: Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords: distress tolerance, smoking cessation, relapse prevention, acceptance and commitment therapy, exposure therapy, experiential avoidance, nicotine withdrawal symptoms, negative mood, nicotine patch, abstinence
MeSH terms: Adolescent, Adult, Affect, Aged, Behavior Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nicotine, Smoking, Substance Withdrawal Syndrome, Time Factors, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Young Adult, Tobacco Use Cessation Devices

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Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse

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