Source: DGNews  |  Posted 2 years ago

By Walter Alexander

DUBLIN, Ireland -- April 29, 2009 -- Adding a mood management component as an adjunct to telephone counselling boosts smoking cessation success rates, but does not prevent recurrence of depressive symptoms, according to a study presented here at the 2009 Joint Conference of the Society for Research on Nicotine and Tobacco (SRNT) and SRNT-Europe.

Regina M. van der Meer, MPH, STIVORO for a Smoke-Free Future, The Hague, the Netherlands, presented the results of the randomised controlled trial on April 28.

Prior research has shown that cessation attempts in smokers with past major depression histories fail considerably more often than in other smokers. Whether postcessation major depression recurrence explains this difficulty or not remains uncertain.

Because it is known also that smokers use cigarettes as a form of self-medication for coping with depressive symptoms, the researchers hypothesised that adding a mood management component to telephone counselling may increase smoking cessation rates and help prevent recurrence of depressive symptoms.

A control group (n = 242) received telephone counselling by trained counsellors in 8 sessions with the first 30-minute session occurring prior to the smoking quit date. The active treatment group (n = 243) received similar counselling, but with 2 additional sessions before the quit date aimed at teaching mood management (MM) skills.

Participants were daily smokers, aged 18 to 65 years, in preparation stages of smoking cessation with past major depression according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria, but not currently with major depression or using antidepressants.

The primary outcome was prolonged abstinence. Point prevalence was assessed (nonsmoking in previous week confirmed by carbon monoxide testing) and depressive symptoms were measured using the Center for Epidemiologic Studies-Depression Scale (CES-D) questionnaire. The questions deal with mood, irritability, calories/energy, concentration, and sleep, and are scored from 0 (rarely) to 3 (most of the time) for a maximum of 30 points.

Mean age was about 43.8 years. The majority of individuals (76.5%) were female. Subjects smoked a mean of 21.6 cigarettes per day and had made an average of 5.2 prior attempts to quit smoking.

At 6 months, the prolonged abstinence rate was significantly higher in the MM group at 30.5% (n = 74), compared with 22.3% (n = 54) among controls. The point prevalence rate also favoured the MM group (37.4% vs 31.0%), although this was not significant (NS). Findings were similar at 12 months for prolonged abstinence (23.9% vs 14.0%) and for point prevalence (27.6% vs 24.0%, NS).

There was no significant difference on depressive symptoms based on CES-D symptom scores at 6 months (15.4 MM vs 14.8 controls) or at 12 months (14.8 MM vs 14.7 controls). Recurrence of major depression was not measured.

Van der Meer concluded that in smokers with past major depression, a mood management component as an adjunct to telephone counselling appears to boost smoking cessation success rates.

Funding for this study was provided by the Netherlands Organisation for Health Research and Development.

[Presentation Title: Effectiveness of a Mood Management Component as an Adjunct to a Telephone Counseling Smoking Cessation Intervention for Smokers With Past Major Depression: A Randomized, Controlled Trial. Abstract PA2-5]