Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability

Abstract

Background: Smokers with substance use disorders (SUD) smoke approximately four times more than the general population. Current efforts are focused on improving smoking cessation treatments for this population. Episodic future thinking (EFT), a novel intervention aimed at decreasing impulsive choice, has shown promising results for reducing cigarette demand in experimental settings. This feasibility study sought to examine the feasibility and preliminary EFT effects on delay discounting (DD) and nicotine intake reductions throughout treatment.

Method: Smokers in substance use treatment (N = 29; 75.9% males) received an 8-week cognitive-behavioral treatment (CBT) + EFT for smoking cessation. The study assessed feasibility through successful recruitment rates, retention, and adherence to treatment. Participants' satisfaction acted as our acceptability measure. We computed nonparametric range tests to analyze changes in continuous variables.

Results: Among interested individuals, 42 (43.75%) met the inclusion criteria, and 29 entered the treatment program. Rate of treatment completion was 65.5% (19/29). Mean (SD) sessions attended were 7(1.11), and mean patient satisfaction rating with treatment was 8.83/10. The study observed low compliance with EFT, with 15.8% (3/19) of patients practicing at least 50% of the requested times.

Conclusions: CBT + EFT is acceptable for the SUD population. However, future studies should implement some adjustments to improve the adherence and feasibility of EFT, such as reducing the number of practices and temporal intervals in EFT events. Given the small sample size, and the absence of a control group, future larger scale trials are needed to elucidate EFT effects on DD and smoking cessation.

Keywords: Delay discounting; Episodic future thinking; Smoking cessation; Substance use disorder.