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Development of a targeted behavioral treatment for smoking cessation among individuals with Chronic Obstructive Pulmonary Disease

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Abstract

Objective

Smoking cessation for individuals with Chronic Obstructive Pulmonary Disease (COPD) is medically critical, but smoking for coping motives is a common barrier.

Method

In this evaluation of three treatment components (Mindfulness, Practice Quitting, and Countering Emotional Behaviors), we conducted two studies guided by the ORBIT model. Study 1 was a single-case design experiment (N = 18); Study 2 was a pilot feasibility study (N = 30). In both studies, participants were randomized to receive one of the three treatment modules. Study 1 examined implementation targets, changes in smoking for coping motives, and changes in smoking rate. Study 2 examined overall feasibility and participant-rated acceptability, and changes in smoking rate.

Results

Study 1: Treatment implementation targets were met by 3/5 Mindfulness participants, 2/4 Practice Quitting participants, and 0/6 Countering Emotional Behaviors participants. The Practice Quitting condition led to 100% of participants meeting the clinically significant threshold in smoking for coping motives. Incidence of quit attempts ranged from 0–50%, and smoking rate was reduced by 50% overall. Study 2: Recruitment and retention met feasibility targets, with 97% of participants completing all four treatment sessions. Participants reported high treatment satisfaction by qualitative responses and rating scales (M = 4.8/ 5.0). Incidence of quit attempts ranged from 25–58%, and smoking rate was reduced by 56% overall.

Conclusions

These two small-N studies provide complementary findings on internal validity and implementation of the novel intervention. While Study 1 provided initial support for plausibility of clinically significant change, Study 2 provided data on key feasibility parameters.

Implications

Smoking cessation for individuals with COPD is medically critical. We conducted an early-phase evaluation of a novel behavioral treatment focused on reducing smoking for coping motives. Results provided initial support for plausibility of clinically significant change and feasibility of the intervention.

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Availability of data and material.

De-identified data from this study are not available in a public archive. De-identified data from this study will be made available (as allowable according to institutional IRB standards) by emailing the corresponding author.

Code availability.

Code from this study will be made available by emailing the corresponding author.

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Funding

This study was funded by the National Heart, Lung, and Blood Association (K23-HL138165) and the American Lung Association (SB-514748).

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Authors and Affiliations

  1. Rush University Medical Center, Chicago, IL, USA

    Amanda R. Mathew, Elizabeth F. Avery, Patrick Nwanah & Lynda H. Powell

  2. University of Illinois at Chicago, Chicago, IL, USA

    Chelsea Cox

  3. Northwestern University Feinberg School of Medicine, 1700 W. Van Buren St, Ste. 470, 60612, Chicago, IL, USA

    Ravi Kalhan & Brian Hitsman

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  1. Amanda R. Mathew
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  2. Elizabeth F. Avery
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Mathew, A.R., Avery, E.F., Cox, C. et al. Development of a targeted behavioral treatment for smoking cessation among individuals with Chronic Obstructive Pulmonary Disease. J Behav Med 46, 1010–1022 (2023). https://doi.org/10.1007/s10865-023-00411-z

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