An open trial of a Cognitive Behavioural Therapy (CBT)-based smoking cessation plus Varenicline intervention in people with a psychotic disorder

An open trial of a CBT-based intervention for smoking, in conjunction with varenicline. The Intervention: (a) The non-pharmacological component: The intervention will consist of 6 once-weekly sessions of Cognitive Behavioural Therapy (CBT) of 1-hour duration, followed by three 1-hour booster sessions at weeks 8 and 10 and 12. Treatment will be delivered according to our treatment manual. Specific components of therapy include: case formulation and feedback from assessment, psychoeducation, motivation enhancement, mood/craving monitoring, mindfulness training, cognitive restructuring (identifying and managing unhelpful automatic thought patterns), enhancement of non-smoking related activities, pleasant events scheduling, coping with cravings (cigarettes), problem-solving, schema change methods, refusal skills and relapse prevention and/or management. During each therapy session, discussion and skills practice will focus on the particular unhealthy behaviours identified as most important/problematic by the participant. Opportunities will be taken by the therapists to integrate messages/skill development about other lifestyle factors as appropriate. Self-help material is provided throughout the treatment period, according to the unhealthy lifestyle behaviour being discussed in the session. (b) The pharmacological component: Varenicline will be provided to participants at each visit. Dose titration will follow that adopted by Gonzalez and colleagues (2006) and as outlined in the Monthly Index of Medical Specialties (MIMS) Australia (Oct/Nov 2008), viz.: 0.5mg daily for days 1-3; 1mg daily for days 4-7, and 1mg twice daily (the target dose) from days 8 to 84. The dose is administered by oral tablets.