Problem/Objective: During the course of operating a telephone counseling service for smoking cessation for the last seven years and conducting several related clinical trials, the American Cancer Society (ACS) has observed that 40-45% of clients seeking cessation assistance report having a symptom of depression at intake. Further ACS has observed that these clients have lower success rates than clients without this symptom, but that results of a previous study suggest this deficit can be overcome by making relapse prevention sessions available after the completion of regular counseling sessions.

Methods: ACS partnered with the Beck Institute to create a telephone counseling protocol enhanced with cognitive behavioral strategies targeted at depression, and more proactive engagement of social support. In this study, smokers (n=2,192) calling the American Cancer Society for cessation assistance were, after providing consent and meeting eligibility criteria, randomized to receive access to a standard telephone counseling protocol or the enhanced protocol with or without access to additional relapse prevention sessions four and eight weeks after the completion of counseling.

Results: At intake 48% of the subjects reported having the symptom of depression. Follow-up surveys were conducted by telephone four months following intake to assess quitting success (response rate=45%). Cessation rates were significantly lower for the group reporting a symptom of depression (p=0.01) and no significant improvement was observed among those who had access to the enhanced protocol or additional relapse prevention sessions.

Conclusions: Enhancing the telephone counseling protocol with brief cognitive therapy for depression did not improve short-term cessation rates.