Smoking cessation for pregnant smokers: Development and pilot test of an emotion regulation treatment supplement to standard smoking cessation for negative affect smokers

Clara M. Bradizza, Paul R. Stasiewicz, Yue Zhuo, Melanie Ruszczyk, Stephen A. Maisto, Joseph F. Lucke, Thomas H. Brandon, Rina D. Eiden, Kim S. Slosman, Paulette Giarratano

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Introduction: Negative affect has been identified as a factor influencing continued smoking during pregnancy. In this study, a multi-component emotion regulation intervention was developed to address negative emotional smoking triggers and pilot-tested among low-income pregnant smokers. Treatment feasibility and acceptability, cotinine-verified rates of smoking cessation, and selfreport of mean cigarettes smoked were assessed. Methods: Pregnant smokers who self-reported smoking in response to negative affect (N = 70) were randomly assigned to receive one of two 8-session interventions: (1) emotion regulation treatment combined with standard cognitive-behavioral smoking cessation (ERT + CBT) or (2) a health and lifestyle plus standard smoking cessation active control (HLS + CBT). Outcomes for the 4-month period following the quit date are reported. Results: Treatment attendance and subjective ratings provide evidence for the feasibility and acceptability of the ERT + CBT intervention. Compared with the HLS + CBT control condition, the ERT + CBT condition demonstrated higher abstinence rates at 2 months (ERT + CBT = 23% vs. HLS + CBT = 0%, OR = 13.51; 95% CI = 0.70-261.59) and 4 months (ERT = 18% vs. HLS = 5%; OR = 2.98; 95% CI = 0.39-22.72) post-quit. Mean number of cigarettes per day was significantly lower in ERT + CBT at 2 months (ERT + CBT = 2.73 (3.35) vs. HLS + CBT = 5.84 (6.24); p =.05) but not at 4 months (ERT + CBT = 2.15 (3.17) vs. HLS + CBT = 5.18 (2.88); p =.06) post-quit. Conclusions: The development and initial test of the ERT + CBT intervention supports its feasibility and acceptability in this difficult-to-treat population. Further development and testing in a Stage II randomized clinical trial are warranted. Implications: Negative affect has been identified as a motivator for continued smoking during pregnancy. To date, smoking cessation interventions for pregnant smokers have not specifically addressed the role of negative affect as a smoking trigger. This treatment development pilot study provides support for the feasibility and acceptability of a multi-component ERT + CBT for low-income pregnant smokers who self-report smoking in response to negative affect. Study findings support further testing in a fully-powered Stage II efficacy trial powered to assess mediators and moderators of treatment effects.

Original languageEnglish (US)
Pages (from-to)578-584
Number of pages7
JournalNicotine and Tobacco Research
Volume19
Issue number5
DOIs
StatePublished - Jan 1 2017

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

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    Bradizza, C. M., Stasiewicz, P. R., Zhuo, Y., Ruszczyk, M., Maisto, S. A., Lucke, J. F., Brandon, T. H., Eiden, R. D., Slosman, K. S., & Giarratano, P. (2017). Smoking cessation for pregnant smokers: Development and pilot test of an emotion regulation treatment supplement to standard smoking cessation for negative affect smokers. Nicotine and Tobacco Research, 19(5), 578-584. https://doi.org/10.1093/ntr/ntw398