The 13th World Conference on Tobacco OR Health

Objective: Approximately 75% of patients with schizophrenia are nicotine dependent, and many die of smoking related illnesses. They generally respond poorly to traditional nicotine dependence treatments, and do not have access to appropriately modified treatment. There is a great need to develop innovative and well-defined behavioral therapies for this population. Such therapies should reflect the unique needs of this population, and capitalize on principles and strategies that are successful in mental health and substance abuse settings. This approach integrates and modifies traditional nicotine dependence and psychiatric treatments.

Methods: Treating Addiction to Nicotine in Schizophrenia (TANS) NIDA Stage I Behavioral Therapy Development Study was developed by our group for motivated smokers and uses approaches common to DRT, including integrating and modifying Motivational Enhancement Therapy, Relapse Prevention, specific tobacco dependence treatments and Social Skills Training into a single therapy approach. TANS is a once weekly, individual, six-month treatment program (24 sessions in 6 months) which is compared to a less intensive (9 week) control treatment called Medication Management (MM). All patients receive the nicotine patch.

Results: Results from the Phase 1a uncontrolled trial of 22 subjects found heavy smoking at baseline (Mean 23 cpd, expired CO 20, FTND 10) and improvements in about 50% of the subjects in regards to total abstinence and reduction of cigarette use, including 59.1% making a quit attempt. The larger Phase 1B controlled trial of 100 subjects is currently underway. Manuals were developed and refined for both conditions and a two day training for community clinicians was also developed.