Session 2 (50 mins)
depressed mood
SESSION, HEART
Session 2 will begin assessment of smoking status, nicotine patch use, and degree of motivation to quit/stay quit, and a discussion of between session mood. If the participant is abstinent, the counselor will reinforce their effort, discuss times since last session when participant struggled with cravings, review strategies for managing triggers and cravings, and problem-solve upcoming challenges to staying quit. If the participant is smoking, the counselor will reinforce any efforts that the participant made (i.e., cutting down), discuss cause of relapse and problem-solve potential solutions to avoid that cause in the future, and utilize brief motivational strategies to prompt another quit attempt. If the participant is willing, the counselor will assist in planning a new quit attempt.The counselor will also introduce BA mood management in session 2. The importance of addressing depressed mood after a hospitalization for ACS and the rationale for BAT-CS (i.e., loss of valued activities causes depressed mood; poor mood can interfere with smoking cessation) will be discussed with the participant. Next the counselor will conduct a values assessment to guide future activation goals The participant and counselor will then collaboratively set 2–4 activation goals to be completed before the next session. These goals will be guided by the values assessment, replacement of any restricted activities, and consistency with a non-smoking lifestyle. All goals will be within current physical abilities and will take into account that the participant is trying to quit smoking (e.g., goals should not involve increased contact with smoking triggers). The counselor will help problem-solve barriers to goal completion using established BA techniques (e.g., stimulus control, accessing social support) to maximize likelihood of completion. At the end of session 2 the counselor will provide a written list of stated values and immediate activation goals. With the participant’s permission, study staff will send an email or text message between sessions to remind and encourage the patient to complete their goals.The participant will also be provided with an American Heart Association patient education booklet entitled 