{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:53:34Z","timestamp":1792086814197,"version":"4.4.0"},"posted":{"date-parts":[[2025,8,24]]},"group-title":"Oncology","reference-count":54,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T00:00:00Z","timestamp":1755993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"award":["P30CA012197"],"award-info":[{"award-number":["P30CA012197"]}],"id":[{"id":"https:\/\/ror.org\/040gcmg81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,10,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite evidence that quitting smoking improves cancer treatment and outcomes, about one in eight patients with cancer smokes cigarettes. Barriers to quitting include difficulty managing cancer-related emotions and distress without smoking and low self-efficacy for quitting. Patients who continue to smoke may benefit from targeted therapies beyond motivational and cognitive approaches commonly used in standard-of-care smoking cessation treatment. Previous studies using Dialectical Behavior Therapy \u2013 Skills Training (DBT-ST) successfully improved coping skills and outcomes for patients with substance use disorders and patients with breast cancer, but DBT-ST has yet to be applied to smoking among cancer populations. We developed an eight-session virtual group DBT-ST intervention to teach mindfulness, emotion regulation, and distress tolerance coping skills to patients with cancer who continue to smoke.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Primary Aim<\/jats:title>\n                  <jats:p>To improve our intervention before feasibility testing in a clinical trial, we solicited critiques and commentary on key intervention components from patients with cancer and smoking histories and their multidisciplinary clinical team.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    Within a pragmatist paradigm, we used qualitative description to conduct semi-structured qualitative interviews with two groups: patients with cancer who smoked or had quit (\n                    <jats:italic>n<\/jats:italic>\n                    =8) and oncology clinicians (physicians, psychotherapists, and nurses\n                    <jats:italic>n<\/jats:italic>\n                    =9). The interviews were analyzed using codebook thematic analysis.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients and clinicians supported intervention components for smoking cessation, particularly its group format and teaching DBT-ST skills for being present, managing emotions, and handling distress. Participants noted perceived benefits including improved quality of life, decreased anxiety and depression, and acquisition of universal skills for managing life\u2019s challenges. Other components, such as a virtual setting and the inclusion of patients not ready to quit, received mixed reviews.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Results indicate early enthusiasm for our DBT-ST intervention for patients with cancer who smoke cigarettes, supporting progression to a feasibility study following specified modifications to intervention components.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Highlights<\/jats:title>\n                  <jats:p>Continued smoking after cancer diagnosis is associated with poorer outcomes.<\/jats:p>\n                  <jats:p>We designed an original program to reduce reliance on smoking as a coping strategy.<\/jats:p>\n                  <jats:p>The program teaches stress management, emotion regulation, and mindfulness skills.<\/jats:p>\n                  <jats:p>Patients and oncology clinicians provided feedback on key proposed intervention components.<\/jats:p>\n                  <jats:p>Feedback informed targeted intervention refinements for future feasibility testing.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.08.19.25334013","type":"posted-content","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T01:40:16Z","timestamp":1756086016000},"source":"Crossref","is-referenced-by-count":0,"title":["A Dialectical Behavior Therapy \u2013 Skills Training Intervention for Cigarette Smoking by Patients with Cancer: Qualitative Descriptive Study of Intervention Components Prior to Feasibility Trial"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4206-1648","authenticated-orcid":false,"given":"Marcia H.","family":"McCall","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavior Medicine, Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5005-8599","authenticated-orcid":false,"given":"Charlotte T.","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0829-7018","authenticated-orcid":false,"given":"Nicole D.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavior Medicine, Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4313-0510","authenticated-orcid":false,"given":"Sherona R.","family":"Sirkisoon","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8018-0395","authenticated-orcid":false,"given":"Ellen A.","family":"Nicola","sequence":"additional","affiliation":[{"name":"Behavioral Health, U.S. Veterans Administration Health Care Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4632-6110","authenticated-orcid":false,"given":"Erica","family":"Fox","sequence":"additional","affiliation":[{"name":"Psychosocial Oncology Program, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6549-009X","authenticated-orcid":false,"given":"Lindsay K.","family":"Seigenthaler","sequence":"additional","affiliation":[{"name":"Community Mental Health Therapist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5606-6146","authenticated-orcid":false,"given":"Stephanie S.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2660-8383","authenticated-orcid":false,"given":"Erin L.","family":"Sutfin","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026101510401798000_2025.08.19.25334013v5.1","unstructured":"ATLAS.ti Scientific Software Development GmbH. 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