Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-16T19:15:50.179Z Has data issue: false hasContentIssue false
  • English
  • Français

Integrating a Behavioural Sleep Intervention into Smoking Cessation Treatment for Smokers with Insomnia: A Randomised Pilot Study

Published online by Cambridge University Press:  16 August 2013

Lisa M. Fucito ,
Nancy S. Redeker ,
Samuel A. Ball ,
Benjamin A. Toll ,
Jolomi T. Ikomi  and
Kathleen M. Carroll
Lisa M. Fucito*
Affiliation:
Yale School of Medicine, Department of Psychiatry
Nancy S. Redeker
Affiliation:
Yale School of Nursing
Samuel A. Ball
Affiliation:
Yale School of Medicine, Department of Psychiatry
Benjamin A. Toll
Affiliation:
Yale School of Medicine, Department of Psychiatry Yale Cancer Center Smilow Cancer Hospital at Yale-New Haven
Jolomi T. Ikomi
Affiliation:
Yale School of Medicine, Department of Psychiatry
Kathleen M. Carroll
Affiliation:
Yale School of Medicine, Department of Psychiatry
*
*Address for correspondence: Lisa M. Fucito, PhD, Yale School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA, E-mail: lisa.fucito@yale.edu, Telephone: +1-203-974-5759
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.

Type
Articles
Information
Journal of Smoking Cessation , Volume 9 , Issue 1 , June 2014 , pp. 31 - 38
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Lung Association. (2013). Freedom From Smoking. Retrieved April 12, 2013, from http://www.ffsonline.org/.Google Scholar
Augustson, E. M., Wanke, K. L., Rogers, S., Bergen, A. W., Chatterjee, N., Synder, K., et al. (2008). Predictors of sustained smoking cessation: a prospective analysis of chronic smokers from the alpha-tocopherol Beta-carotene cancer prevention study. American Journal of Public Health, 98 (3), 549–555.Google Scholar
Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2 (4), 297–307.CrossRefGoogle ScholarPubMed
Baumeister, R. F., Vohs, K. D., DeWall, C. N., & Zhang, L. (2007). How emotion shapes behavior: feedback, anticipation, and reflection, rather than direct causation. Personality & Social Psychology Review, 11 (2), 167–203.Google Scholar
Boutou, A. K., Tsiata, E. A., Pataka, A., Kontou, P. K., Pitsiou, G. G., & Argyropoulou, P. (2008). Smoking cessation in clinical practice: predictors of six-month continuous abstinence in a sample of Greek smokers. Primary Care Respiratory Journal, 17 (1), 32–38.Google Scholar
Bover, M. T., Foulds, J., Steinberg, M. B., Richardson, D., & Marcella, S. W. (2008). Waking at night to smoke as a marker for tobacco dependence: patient characteristics and relationship to treatment outcome. Internationl Journal of Clinical Practice, 62 (2), 182–190.Google Scholar
Brower, K. J., & Perron, B. E. (2010). Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances. Medical Hypotheses, 74 (5), 928–933.Google Scholar
Brown, R. A., Burgess, E. S., Sales, S. D., Whiteley, J. A., Evans, D. M., & Miller, I. W. (1998). Reliability and validity of a smoking timeline follow-back interview. Addiction, 93 (6), 912–913.Google Scholar
Buysse, D. J., Reynolds, C. F., Monk, T. H. 3rd, Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28 (2), 193–213.Google Scholar
CDC. (2011, January 26, 2011). You Can Quit Smoking. Smoking and Tobacco Use. Retrieved April 12, 2013, from http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/you_can_quit/Google Scholar
Chiou, W. B., Wu, W. H., & Chang, M. H. (2013). Think abstractly, smoke less: a brief construal-level intervention can promote self-control, leading to reduced cigarette consumption among current smokers. Addiction, 108 (5), 985–992.Google Scholar
Cohen, J. (1998). Statistical power analysis of the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum.Google Scholar
Fiore, M. C., Jaen, C. R., Baker, T. B., Bailey, W. C., Benowitz, N. L., Curry, S. J., et al. (2008). Treating tobacco use and dependence: 2008 update. clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, research version, patient edition with psychotic screen (SCID-I/P W/PSY SCREEN). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Ford, D. E., & Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? Journal of American Medical Association, 262 (11), 1479–1484.Google Scholar
Fortier-Brochu, E., Beaulieu-Bonneau, S., Ivers, H., & Morin, C. M. (2012). Insomnia and daytime cognitive performance: a meta-analysis. Sleep Medicine Reviews, 16 (1), 83–94.Google Scholar
Foulds, J., Gandhi, K. K., Steinberg, M. B., Richardson, D. L., Williams, J. M., Burke, M. V., & Rhoads, G. G. (2006). Factors associated with quitting smoking at a tobacco dependence treatment clinic. Americal Journal of Health Behavior, 30 (4), 400–412.CrossRefGoogle Scholar
Heatherton, T. F., Kozlowski, L.T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86 (9), 1119–1127.Google Scholar
Hedges, L.V. (1981). Distribution theory for Glass's estimator of effect size and related estimators. Journal of Educational Statistics, 6, 107–128.Google Scholar
Hughes, J. R. (2007). Effects of abstinence from tobacco: valid symptoms and time course. Nicotine & Tobacco Research, 9 (3), 315–327.CrossRefGoogle ScholarPubMed
Hughes, J. R., Callas, P.W., & Peters, E. N. (2007). Interest in gradual cessation. Nicotine & Tobacco Research, 9 (6), 671–675.Google Scholar
Hughes, J. R., Solomon, L. J., Livingston, A. E., Callas, P. W., & Peters, E. N. (2010). A randomized, controlled trial of NRT-aided gradual vs. abrupt cessation in smokers actively trying to quit. Drug & Alcohol Dependence, 111 (1–2), 105–113.Google Scholar
Hyland, A., Li, Q., Bauer, J. E., Giovino, G. A., Steger, C., & Cummings, K. M. (2004). Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine & Tobacco Research, 6 Suppl3, S363–369.Google Scholar
Jaehne, A., Unbehaun, T., Feige, B., Lutz, U. C., Batra, A., & Riemann, D. (2012). How smoking affects sleep: a polysomnographical analysis. Sleep Medicine, 13 (10), 1286–1292.CrossRefGoogle ScholarPubMed
Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14 (6), 540–545.Google Scholar
Kraemer, H. C., Mintz, J., Noda, A., Tinklenberg, J., & Yesavage, J. A. (2006). Caution regarding the use of pilot studies to guide power calculations for study proposals. Archives of General Psychiatry, 63 (5), 484–489.Google Scholar
Monk, T. H., Reynolds, C. F., Kupfer, D. J., Buysse, D. J., Coble, P. A., Hayes, A. J., et al. (1994). The Pittsburgh Sleep Diary. Journal of Sleep Research, 3, 111–120.Google Scholar
Morin, C. M. (2004). Cognitive-behavioral approaches to the treatment of insomnia. Journal of Clinical Psychiatry, 65 Suppl16, 33–40.Google Scholar
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep, 29 (11), 1398–1414.CrossRefGoogle ScholarPubMed
Morin, C. M., & Espie, C. A. (2003). Insomnia: a clinical guide to assessment and treatment. New York: Kluwer Academic/Plenum Publishers.Google Scholar
Mueser, K. T., Noordsy, D. L., Drake, R. E., & Fox, L. (2003). Integrated Treatment for Dual Disorders: a guide to effective practice. New York: Guilford Press.Google Scholar
Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999). Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Annals of Internal Medicine, 131 (7), 485–491.Google Scholar
Perlis, M. L., Jungquist, C. R., Smith, M.T., & Posner, D. (2005). Cognitive Behavioral Treatment of Insomnia: a session-by-session guide. New York: Springer.Google Scholar
Peters, E. N., Fucito, L. M., Novosad, C., Toll, B. A., & O'Malley, S. S. (2011). Effect of night smoking, sleep disturbance, and their co-occurrence on smoking outcomes. Psychology of Addictive Behaviors, 25 (2), 312–319.Google Scholar
Phillips, B. A., & Danner, F. J. (1995). Cigarette smoking and sleep disturbance. Archives of Internal Medicine, 155 (7), 734–737.Google Scholar
Piper, M. E., Smith, S. S., Schlam, T. R., Fiore, M. C., Jorenby, D. E., Fraser, D., & Baker, T. B. (2009). A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Archives of General Psychiatry, 66 (11), 1253–1262.CrossRefGoogle ScholarPubMed
Rennard, S., Hughes, J., Cinciripini, P. M., Kralikova, E., Raupach, T., Arteaga, C., et al.; Flexible Quit Date Study Group. (2012). A randomized placebo-controlled trial of varenicline for smoking cessation allowing flexible quit dates. Nicotine & Tobacco Research, 14 (3), 343–350.CrossRefGoogle ScholarPubMed
Riedel, B. W., Durrence, H. H., Lichstein, K. L., Taylor, D. J., & Bush, A. J. (2004). The relation between smoking and sleep: the influence of smoking level, health, and psychological variables. Behavioral Sleep Medicine, 2 (1), 63–78.Google Scholar
Sánchez-Meca, J., Marín-Martínez, F., & Chacón-Moscoso, S. (2003). Effect-size indices for dichotomized outcomes in meta-analysis. Psychological Methods, 8, 448–467.Google Scholar
Scharf, D. M., Dunbar, M. S., & Shiffman, S. (2008). Smoking during the night: prevalence and smoker characteristics. Nicotine & Tobacco Research, 10 (1), 167–178.Google Scholar
Shiffman, S., Ferguson, S. G., & Strahs, K. R. (2009). Quitting by gradual smoking reduction using nicotine gum: a randomized controlled trial. Americal Journal of Preventive Medicine, 36 (2), 96–104.e1.CrossRefGoogle ScholarPubMed
Shiffman, S., Hughes, J. R., Ferguson, S. G., Pillitteri, J. L., Gitchell, J. G., & Burton, S. L. (2007). Smokers’ interest in using nicotine replacement to aid smoking reduction. Nicotine & Tobacco Research, 9 (11), 1177–1182.Google Scholar
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. American Journal of Psychiatry, 159 (1), 5–11.CrossRefGoogle ScholarPubMed
Soldatos, C. R., Kales, J. D., Scharf, M. B., Bixler, E. O., & Kales, A. (1980). Cigarette smoking associated with sleep difficulty. Science, 207 (4430), 551–553.Google Scholar
SRNT Subcommittee on Biochemical Verification (2002). Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4 (2), 149–159.Google Scholar
Strecher, V. J., Rimer, B. K., & Monaco, K. D. (1989). Development of a new self-help guide—Freedom From Smoking for you and your family. Health Education Quarterly, 16 (1), 101–112.Google Scholar
Vangeli, E., Stapleton, J., Smit, E. S., Borland, R., & West, R. (2011). Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction, 106 (12), 2110–2121.Google Scholar
West, R., Hajek, P., Stead, L., & Stapleton, J. (2005). Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction, 100 (3), 299–303.Google Scholar
Wetter, D.W., & Young, T. B. (1994). The relation between cigarette smoking and sleep disturbance. Preventive Medicine, 23 (3), 328–334.Google Scholar
Zhang, L., Samet, J., Caffo, B., & Punjabi, N. M. (2006). Cigarette smoking and nocturnal sleep architecture. American Journal of Epidemiology, 164 (6), 529–537.Google Scholar
Zhou, X., Nonnemaker, J., Sherrill, B., Gilsenan, A.W., Coste, F., & West, R. (2009). Attempts to quit smoking and relapse: factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviors, 34 (4), 365–373.Google Scholar