Trial Outcomes & Findings for CPT-SMART for Treatment of PTSD and Cigarette Smoking (NCT NCT03978442)
NCT ID: NCT03978442
Last Updated: 2026-07-02
Results Overview
7-day point prevalence abstinence is defined as no smoking in the prior 7 days.
Recruitment status
COMPLETED
Study phase
PHASE4
Target enrollment
115 participants
Primary outcome timeframe
6 month follow-up, up to 7 months from baseline
Results posted on
2026-07-02
Participant Flow
Participant milestones
| Measure |
CPT-SMART
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Randomization to Post-Treatment
STARTED
|
60
|
55
|
|
Randomization to Post-Treatment
COMPLETED
|
47
|
38
|
|
Randomization to Post-Treatment
NOT COMPLETED
|
13
|
17
|
|
Post-Treatment to 4-Month Follow-Up
STARTED
|
47
|
38
|
|
Post-Treatment to 4-Month Follow-Up
COMPLETED
|
41
|
30
|
|
Post-Treatment to 4-Month Follow-Up
NOT COMPLETED
|
6
|
8
|
|
4-Month to 6-Month Follow-Up
STARTED
|
41
|
30
|
|
4-Month to 6-Month Follow-Up
COMPLETED
|
39
|
27
|
|
4-Month to 6-Month Follow-Up
NOT COMPLETED
|
2
|
3
|
Reasons for withdrawal
| Measure |
CPT-SMART
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Randomization to Post-Treatment
Lost to Follow-up
|
8
|
8
|
|
Randomization to Post-Treatment
Withdrawal by Subject
|
5
|
9
|
|
Post-Treatment to 4-Month Follow-Up
Lost to Follow-up
|
3
|
4
|
|
Post-Treatment to 4-Month Follow-Up
Withdrawal by Subject
|
3
|
4
|
|
4-Month to 6-Month Follow-Up
Lost to Follow-up
|
2
|
1
|
|
4-Month to 6-Month Follow-Up
Withdrawal by Subject
|
0
|
2
|
Baseline Characteristics
CPT-SMART for Treatment of PTSD and Cigarette Smoking
Baseline characteristics by cohort
| Measure |
CPT-SMART
n=60 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=55 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
Total
n=115 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
54.3 years
STANDARD_DEVIATION 11.30 • n=20 Participants
|
52.55 years
STANDARD_DEVIATION 11.67 • n=20 Participants
|
53.46 years
STANDARD_DEVIATION 11.46 • n=40 Participants
|
|
Sex: Female, Male
Female
|
13 Participants
n=20 Participants
|
15 Participants
n=20 Participants
|
28 Participants
n=40 Participants
|
|
Sex: Female, Male
Male
|
47 Participants
n=20 Participants
|
40 Participants
n=20 Participants
|
87 Participants
n=40 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
0 Participants
n=20 Participants
|
3 Participants
n=20 Participants
|
3 Participants
n=40 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
59 Participants
n=20 Participants
|
51 Participants
n=20 Participants
|
110 Participants
n=40 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
1 Participants
n=20 Participants
|
1 Participants
n=20 Participants
|
2 Participants
n=40 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
2 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
2 Participants
n=40 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
0 Participants
n=40 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
0 Participants
n=40 Participants
|
|
Race (NIH/OMB)
Black or African American
|
25 Participants
n=20 Participants
|
24 Participants
n=20 Participants
|
49 Participants
n=40 Participants
|
|
Race (NIH/OMB)
White
|
31 Participants
n=20 Participants
|
29 Participants
n=20 Participants
|
60 Participants
n=40 Participants
|
|
Race (NIH/OMB)
More than one race
|
1 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
1 Participants
n=40 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
1 Participants
n=20 Participants
|
2 Participants
n=20 Participants
|
3 Participants
n=40 Participants
|
|
Region of Enrollment
United States
|
60 Participants
n=20 Participants
|
55 Participants
n=20 Participants
|
115 Participants
n=40 Participants
|
PRIMARY outcome
Timeframe: 6 month follow-up, up to 7 months from baselinePopulation: Based on participants who completed the 6-month follow-up. 5 participants were not included in this analysis due to missing data (4 from CPT-SMART group, 1 from CCYC)
7-day point prevalence abstinence is defined as no smoking in the prior 7 days.
Outcome measures
| Measure |
CPT-SMART
n=35 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=26 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Whose Self-report of 7 Day Point Prevalence Abstinence From Smoking is Bioverified
|
16 Participants
|
15 Participants
|
SECONDARY outcome
Timeframe: 6 month follow-up, up to 7 months from baselinePopulation: Based on participants who completed the 6-month follow-up. 7 participants were not included in this analysis due to missing data (5 from CPT-SMART group, 2 from CCYC)
30-day point prevalence abstinence is defined as no smoking in the prior 30 days.
Outcome measures
| Measure |
CPT-SMART
n=34 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=25 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Whose Self-report of 30 Day Point Prevalence Abstinence From Smoking is Bioverified
|
12 Participants
|
14 Participants
|
SECONDARY outcome
Timeframe: 4 month follow-up, up to 5 months from baselinePopulation: Based on participants who completed the 4-month follow-up. 7 participants were not included in this analysis due to missing data (5 from CPT-SMART group, 2 from CCYC)
7-day point prevalence abstinence is defined as no smoking in the prior 7 days.
Outcome measures
| Measure |
CPT-SMART
n=36 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=28 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Whose Self-report of 7 Day Point Prevalence Abstinence From Smoking is Bioverified
|
18 Participants
|
16 Participants
|
SECONDARY outcome
Timeframe: 4 month follow-up, up to 5 months from baselinePopulation: Based on participants who completed the 4-month follow-up. 12 participants were not included in this analysis due to missing data (8 from CPT-SMART group, 4 from CCYC)
30-day point prevalence abstinence is defined as no smoking in the prior 30 days.
Outcome measures
| Measure |
CPT-SMART
n=33 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=26 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Whose Self-report of 30 Day Point Prevalence Abstinence From Smoking is Bioverified
|
14 Participants
|
13 Participants
|
SECONDARY outcome
Timeframe: 4 month follow-up, up to five months from baselinePopulation: Based on participants who completed the 4-month follow-up. 14 participants were not included in this analysis due to missing data (9 from CPT-SMART group, 5 from CCYC)
Prolonged abstinence is defined as 30 days abstinent.
Outcome measures
| Measure |
CPT-SMART
n=32 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=25 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Who Self-report Prolonged Abstinence
|
14 Participants
|
13 Participants
|
SECONDARY outcome
Timeframe: 6 month follow-up, up to 7 months from baselinePopulation: Based on participants who completed the 6-month follow-up. 6 participants were not included in this analysis due to missing data (4 from CPT-SMART group, 2 from CCYC)
Prolonged abstinence is defined as 30 days abstinent.
Outcome measures
| Measure |
CPT-SMART
n=35 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=25 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Who Self-report Prolonged Abstinence
|
12 Participants
|
12 Participants
|
SECONDARY outcome
Timeframe: Measured at the post-treatment visit (2 weeks after treatment completed), up to 4.5 months from baselinePopulation: Based on participants who completed the post-treatment follow-up. 6 participants were not included in this analysis due to missing data (5 from CPT-SMART group, 1 from CCYC)
Early abstinence is defined as 2 consecutive sessions abstinent in first month of quit attempt.
Outcome measures
| Measure |
CPT-SMART
n=43 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=38 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Who Self-report Early Abstinence
|
25 Participants
|
22 Participants
|
SECONDARY outcome
Timeframe: Measured at the post-treatment visit (2 weeks after treatment completed), up to 4.5 months from baselineThose who complete eight or more treatment sessions will be considered to have had an adequate treatment dose.
Outcome measures
| Measure |
CPT-SMART
n=60 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=55 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Participants Who Attended Eight or More Sessions of Combined CPT and CBT for Smoking
|
37 Participants
|
32 Participants
|
SECONDARY outcome
Timeframe: Measured at the post-treatment visit (2 weeks after treatment completed), up to 4.5 months from baselinePopulation: Population includes all participants who began treatment.
The average number of treatment sessions attended by participants in each group will be considered a measure of treatment engagement.
Outcome measures
| Measure |
CPT-SMART
n=60 Participants
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=55 Participants
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
Number of Sessions Attended by Participants
|
8.3 sessions
Standard Deviation 4.7
|
7.8 sessions
Standard Deviation 5.0
|
Adverse Events
CPT-SMART
Serious events: 0 serious events
Other events: 11 other events
Deaths: 0 deaths
Combined Contact Yoked Control
Serious events: 0 serious events
Other events: 16 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
| Measure |
CPT-SMART
n=60 participants at risk
COGNITIVE PROCESSING THERAPY with SMOKING ABSTINENCE REINFORCEMENT THERAPY (CPT-SMART) - an intervention that combines evidence-based PTSD treatment with guideline-concordant cognitive-behavioral smoking cessation counseling, bupropion, and intensive behavioral therapy through CM.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Smoking Abstinence Reinforcement Therapy: Monetary reinforcement for smoking abstinence that is bioverified by breath carbon monoxide and saliva samples.
|
Combined Contact Yoked Control
n=55 participants at risk
COMBINED CONTACT YOKED CONTROL (CCYC) - an intervention that is identical to CPT-SMART for PTSD and smoking treatment, except for using non-contingent payment (i.e., yoked CM) to control for compensation and monitoring.
Smoking Cessation Cognitive Behavioral Therapy (CBT): 12 sessions of cognitive behavioral therapy for smoking cessation, designed to help participants prepare for quitting smoking, make a quit attempt, and stay quit from smoking.
Bupropion: All medically eligible participants will be prescribed bupropion to begin 7 days before the quit date and continued through 12 weeks post-quit. Participants will be scheduled to begin at 150mg/day of bupropion for at least 3 days before titrating up to 300mg/day dose of bupropion.
Cognitive Processing Therapy: 12 sessions of CPT, which is a well-established trauma-focused psychotherapy for PTSD that has demonstrated efficacy and effectiveness in Veterans.
Yoked Contingency Management: Participants in the yoked control will receive the monetary reinforcement of their yoked participant regardless of smoking abstinence or session attendance.
|
|---|---|---|
|
General disorders
Bad taste in mouth/dry mouth
|
3.3%
2/60 • Number of events 3 • 6 months
|
12.7%
7/55 • Number of events 7 • 6 months
|
|
General disorders
headache
|
5.0%
3/60 • Number of events 4 • 6 months
|
5.5%
3/55 • Number of events 3 • 6 months
|
|
Psychiatric disorders
increased mood or anxiety symptoms
|
8.3%
5/60 • Number of events 5 • 6 months
|
7.3%
4/55 • Number of events 5 • 6 months
|
|
Nervous system disorders
dizziness
|
5.0%
3/60 • Number of events 3 • 6 months
|
0.00%
0/55 • 6 months
|
|
Psychiatric disorders
insomnia/nightmares
|
3.3%
2/60 • Number of events 2 • 6 months
|
14.5%
8/55 • Number of events 8 • 6 months
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place