Assessment of a psychological treatment for smoking cessation and depressive mood improvement

Resumo

Despite the fact that there exist efficacious smoking cessation psychological treatments, a decrease on treatment efficacy has been observed recently. In addition, the number of people with depressive symptoms who seek smoking cessation treatment has increased. The aim of the present Doctoral Thesis was to assess the efficacy of a psychological treatment to quit smoking with components of Behavioral Activation for depressed mood management. We also sought to examine different depression-related variables and its association with tobacco dependence and smoking cessation outcomes. Eight studies were carried out, including a systematic review, the design of a methodological protocol for conduct a randomized clinical trial and six empirical studies (N = 275). The results showed that Behavioral Activation is a promising therapeutic approach in the context of smoking cessation treatment. The findings of this Doctoral Thesis showed positive effects of integrating this behavioral strategy in terms of abstinence rates at the end of treatment, at three, six and twelve months follow-ups in a sample of participants with and without depressive symptomatology. Specifically, abstinence rates at 12 months follow-up were 30% for the behavioral activation condition and 18% for the standard treatment. In addition, through this work it is shown, in line with the existing literature, that depressive symptomatology is reduced when abstinence is achieved. Therefore, these results should encourage smokers to try to quit smoking not only for physical health-related reasons but also as a way to improve their quality of life, mental health and general well-being. Similarly, the results of this Doctoral Thesis suggest that smokers with depressive symptoms can quit smoking in a similar rate to those who do not depressive symptomatology, despite the fact that they generally have a higher level of tobacco dependence and less confidence in being able to maintain abstinence. Finally, this work also provides additional evidence on psychological, environmental, social and personality-related factors that are implicated in tobacco dependence and in smoking cessation treatment outcomes, such as boredom susceptibility, perceived loneliness, rumination, behavioral avoidance or perceived environmental reward.