An emotion regulation-focused theoretical framework for co-occurring nicotine addiction and PTSD: Comments on existing treatments and future directions

Abstract

The prevalence of smoking among those with posttraumatic stress disorder (PTSD) is 2–6 times higher than the general adult population. Smoking intensifies PTSD symptoms, which in turn, contribute to heavier smoking and even more difficulty quitting. The benefit of integrating smoking cessation interventions into PTSD treatment has been increasingly recognized. However, current treatment programs are either limited in their efficacy or by the challenges of implementation. This commentary presents a theoretical framework depicting emotion regulation mechanisms shared by nicotine addiction and PTSD. We trust that the proposed theoretical framework will promote systematic and mechanism-focused investigation of the existing treatments. Based on this model, we propose a novel smoking cessation treatment model incorporating an emotion regulation focused and empirically supported treatment for PTSD, Skills Training in Affective and Interpersonal Regulation, and standard smoking cessation techniques. We suggest that this novel treatment may be a promising next treatment to investigate.