Quitting smoking following acute coronary syndrome can reduce mortality up to 50%. However,
depression and smoking are highly co-morbid and depressed mood may interfere with cessation
and independently predicts mortality. Thus, a single, integrated treatment for both smoking
and depression could be highly effective in reducing post-acute coronary syndrome mortality.
Behavioral Activation (BA) is a well established treatment for depression and has recently
shown promise as a treatment for smoking cessation. The investigators systematically
developed an intervention integrating gold standard smoking cessation counseling with
existing BA based mood management techniques for post-ACS smokers; Behavioral Activation
Treatment for Cardiac Smokers (BAT-CS).
Objective: For this R56 the investigators will conduct a vanguard trial to pilot all methods,
materials, and systems for the later fully powered BAT-CS vs. attention control trial. The
investigators will enroll up to 36 smokers with ACS and randomize them to 12 weeks of BAT-CS
or an attention control (Health and Wellness Education). Both groups will be offered the
nicotine patch if medically safe.