Behavioral Activation for Smoking Cessation in Veterans With PTSD

The purpose of this study is to examine whether behavioral activation as an adjuvant to
standard smoking cessation treatment improves smoking cessation outcomes among veterans with
PTSD relative to a comparably intense combination of standard smoking cessation treatment +
health and smoking education. It is expected that behavioral activation will produce more
successful results than health and smoking education when paired with standard smoking
cessation treatment.

After an initial phone screen, in-person screening, and baseline assessment, enrolled
participants will be randomized to either behavioral activation therapy and standard smoking
cessation treatment (BA+ST) or health and smoking education and standard smoking cessation
treatment (HSE+ST). Both groups will meet with a therapist once a week for 8 weeks to
receive either BA+ST or HSE+ST. Participants' mood and smoking outcomes will be monitored
throughout the 8 weeks of treatment and at 2 follow-up visits and 2 follow-up phone calls.

Inclusion Criteria:

- Report smoking an average of 10 or more cigarettes daily for at least six months

- Report a desire to quit smoking

- Meet criteria for current PTSD

- Speak and read English

- Agree to participate in the study

- Be ≥ 18 years old

- Be a veteran

Exclusion Criteria:

- Meeting criteria for psychotic or bipolar disorder

- Psychoactive substance abuse or dependence (excluding nicotine dependence) within the
past 6 months

- Inability to give informed, voluntary, written consent to participate

- Current use of any pharmacotherapy for smoking cessation not provided by the
researchers during the quit attempt

- Use of non-cigarette tobacco products as a primary form of tobacco use

- Being currently suicidal or homicidal

- Being medically unable to use the nicotine patch or nicotine gum/lozenge

- Psychotropic medication changes within 3 months of study initiation and during active
treatment

- Current engagement in evidence-based therapies for PTSD or depression

- Pregnant or trying to become pregnant

- Incarceration