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We conducted a systematic literature review and meta-analysis (ID: CRD42016051017) of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP). Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%), pharmacological (6/30%) or combined (8/40%). Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base.

Gambling has been considered a male pastime with research focused on exploring risk factors for gambling without considering gender differences. Despite gambling has greatly increased among women in recent years, few studies have explored gender differences in adolescent gamblers. This study analyzed gender differences in risk factors and gambling-related patterns. The sample comprised 1756 adolescents aged 14 to 17 years. Chisquare and t-tests were performed to examine differences between male and female gamblers (n = 699). Multiple regressions were conducted to explore predictors of gambling severity by gender. Male gamblers reported more gambling activity within the last year and showed a more severe gambling pattern. Impulsivity, last year prevalence of bingo, and other casino games were associated with higher gambling severity in both genders. Enhancement and coping motives were related to gambling severity only in males, while mixed-mode gambling was related to gambling severity in females. Our findings extend the research on gender differences among adolescent gamblers by showing that gender specific risk factors exist and should be regarded by health providers when designing treatment strategies.

Introduction Contingency management (CM) is efficacious for smoking cessation. To date, the number of cost-effectiveness evaluations of behavioral and pharmacological smoking cessation treatments far outnumbers the ones on CM. This study estimated one-year efficacy and incremental cost-effectiveness (ICE) of adding CM in relation to abstinence outcomes for a cognitive-behavioral therapy (CBT)+behavioral activation (BA) treatment. Methods The study sample comprised 120 smokers with depression [% females: 70.8%; mean age: 51.67(SD = 9.59)] enrolled in an 8-week randomized controlled clinical trial. Clinical effectiveness variables were point prevalence abstinence, continuous abstinence, longest duration of abstinence (LDA), and Beck-Depression Inventory-II (BDI-II) scores at one-year follow-up. Cost-effectiveness analyses were based on resource utilization, unit costs per patient, and incremental cost per additional LDA week at one year. Results There was a significant effect of time by treatment group interaction, which indicated superior effects of CBT+BA+CM across time. Point-prevalence abstinence [53.3% (32/60)] was superior in participants receiving CBT+BA+CM compared to those in CBT+BA [23.3% (14/60)], but both groups were equally likely to present sustained reductions in depression. The average cost per patient was €208.85(US$236.57) for CBT+BA and €410.64(US$465.14) for CBT+BA+CM, p<.001. The incremental cost of using CM to enhance one-year abstinence by one extra LDA week was 18€(US$20.39) [95%CI: 17.75-18.25]. Conclusions Behavioral treatments addressing both smoking and depression are efficacious for sustaining high quit rates at one year. Adding CM to CBT+BA for smoking cessation is highly cost-effective, with an estimated net benefit of €4,704 (US$5,344.80). IMPLICATIONS Informing on the cost-effectiveness of CM might expedite the translation of research findings into clinical practice. Findings suggested that CM is feasible and highly cost-effective, confirming that its implementation is worthwhile. At a CM cost per patient of €410.64 (US$465.14), the net benefit equals €4,704 (US$5,344.80), although even starting from a minimum investment of €20 (US$22.72) was cost-effective.

Rationale Reinforcer pathology (RP) is a theoretical model based on two processes: delay discounting (DD) and drug demand. Given that RP has been shown to have a predictive value on smoking behaviors, several studies have explored which interventions can reduce RP. Consistent with the RP framework, episodic future thinking (EFT) has shown effects on treatment outcomes and RP processes. The vast majority of studies that assess the effects of EFT on RP consist of experimental studies, and no previous research has tested these effects in a clinical sample of smokers. Objectives The primary aim of this study was to assess the effects of EFT on RP throughout the course of a smoking cessation intervention in smokers with substance use disorders (SUDs). Methods Participants were randomized to cognitive behavior therapy (CBT) + EFT (n = 39) or CBT + EFT + contingency management (n = 33). Cotinine, frequency of EFT practices, cigarette purchase task (CPT), and DD were evaluated in treatment sessions. Mixed-effects model repeated measures analysis was used to explore DD and CPT in-treatment changes as a function of EFT practices and cotinine levels. Results Greater practice of the EFT component significantly reduced cigarette demand (p < .020) as well as DD (p = .003). Additionally, a greater reduction in cotinine levels coupled with greater EFT practice led to a greater decrease in cigarette demand (p < .014). Conclusions EFT reduced the two facets of RP in treatment-seeking smokers with SUDs.

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