Veterans-and-Smoking Study to Launch in October
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Veterans-and-Smoking Study to Launch in January 2010

Watch Coverage from CBS News:

Post-traumatic stress disorder (PTSD) afflicts an estimated 7.7 million U.S. veterans, and 53 percent of those sufferers smoke. Is there a link? What is it? UW-CTRI Researcher Dr. Jessica Cook aims to find out more through a study launching in January 2010.

PTSD

“Little is known about factors influencing smoking in veterans with PTSD and what their barriers are to quitting,” Cook said. “We are already aware that they smoke at a high rate. But, we are also stepping back and looking at why they smoke more heavily than smokers without PTSD. I'll be looking at two factors that may influence their smoking: negative affect and anhedonia.”

Anhedonia is the inability to respond to what is commonly considered pleasurable. Jessica and research assistant Kirsten Walth have put in months of prep work and are ready to launch a research project looking at 200 veterans over three years. The study groups will be comprised of:

  • 50 smokers with PTSD.
  • 50 smokers with depression.
  • 50 smokers with PTSD and depression.
  • 50 smokers without either diagnosis.

Housed at the VA Medical Center in Madison, the pair will undertake two different studies starting in January 2010 .

 

Jessica Cook
Dr. Jessica Cook

Kirsten Walth
Kirsten Walth

Plans are also in place for a sub-study that pilots a stop-smoking intervention with this population. Each study begins with the hypothesis that the pleasurable sensations a person can get from smoking thanks to the release of dopamine stimulated by nicotine helps regulate the symptoms of PTSD and depression. The effect Cook is most interested in is whether smoking regulates anhedonia.

The first study asks participants to smoke according to their normal pattern during their normal routines, and then report to the laboratory on two different days. When they first enter the laboratory, they smoke one of their own cigarettes and then provide a self-report on their positive and negative moods. During each of two visits to the laboratory, participants undergo three mood inductions—either negative or positive—while smoking a cigarette with nicotine, a cigarette with no nicotine or while holding a pen. Following each mood induction, their mood will be re-assessed. This study will allow the researchers to learn about how nicotine influences mood responses to positive and negative stimuli.

The second study will be done at a critical point—24 and 48 hours after being deprived of nicotine. That can be the peak of withdrawal. It’s then that the team will explore whether veterans with PTSD have a more difficult time experiencing pleasure in response to rewarding events and whether they experience more withdrawal-related negative affect. Salivary cortisol will also be measured to explore whether nicotine deprivation triggers dysregulation in cortisol, a stress hormone associated with PTSD. Prior to and during the 48-hour abstinence period, participants will collect the salivary cortisol to establish comparisons between when they are smoking and when they are abstaining from smoking.

The pilot sub-study has the potential to help individuals quit. It could also further the understanding of behavioral activation counseling to treat PTSD and depression, as well as its efficacy as a stop-smoking intervention. This counseling encourages people to engage in goal-directed and enjoyable activities. Fifteen smokers who want to quit and had participated in the prior two studies will take part in multiple counseling visits conducted either at the VA facility or the offices at UW-CTRI in Madison.

“I am pleased to be able to get this research underway," Cook said. “There are few other findings out there regarding factors influencing smoking among those who suffer from PTSD. Hopefully, these studies will help provide a foundation for eventually developing smoking-cessation treatments tailored for veterans with PTSD and depression.”  

© 2009 UW-CTRI