A Future Thinking Intervention for Comorbid Tobacco Use Disorder and Bipolar Disorder

This is a treatment development study that begins with an open non-randomized pilot trial (N = 10) in which we will test the manual developed for Future Self-BD by assessing the acceptability and feasibility of Future Self-BD. After completion of the non-randomized pilot trial and subsequent revisions to the Future Self-BD manual, we will conduct a parallel randomized controlled trial comparing Future Self-BD (N = 30) to a control treatment, Daily Check-Ins (N = 30). Future Self-BD and Daily Check-Ins involve six, weekly, 1.5-2 hour sessions and one 1.5 hour follow-up session one month after completion of the sixth session; thus, participants will be enrolled in the study for a period of 10 weeks. Assessments will occur at all study sessions.

Inclusion criteria

• Adults aged 18 or older
• Have a diagnosis of BD I or II
• Have a diagnosis of tobacco use disorder
• Be engaged in outpatient treatment with a medical provider
• Be on a stable dose of a mood-stabilizing medication
• Smoke an average of at least 5 cigarettes per day for the past 30 days at baseline (based on the Heaviness of Smoking Index(Heatherton et al., 1989))
• Be interested in quitting smoking
• Not currently or in the past 3 months be receiving smoking cessation treatment.

Exclusion criteria

• Current psychosis
• Intent to harm oneself with an associated plan and intent to act on suicidal thoughts
• Experiencing severe symptoms of depression and/or hypomania that may warrant a higher level of care (a Patient Health Questionnaire-9 total score ≥ 20(Kroenke et al., 2001) and/or an Altman Self-Rating Mania Scale total score ≥ 6(Altman et al., 1997) will trigger further clinician evaluation)