Tobacco Approach Avoidance Training for Adolescent Smokers-2 (AAT-2)

This is a two part study. In Study 2, smokers who want to quit smoking will participate in a 4 week smoking cessation program combining weekly cognitive behavioral therapy (CBT) with weekly regular-AAT or placebo-AAT training. We hypothesize that adolescent smokers will exhibit stronger approach tendencies towards smoking-related stimuli in the tobacco Approach Avoidance Training (AAT) task when compared with nonsmokers and that adolescent smokers who are trained to avoid smoking related stimuli using the AAT will avoid tobacco approach tendencies in the AAT test trials and the Implicit Association Task, when compared to adolescent smokers who are not exposed to AAT training. We also hypothesize that adolescent smokers who are trained to avoid tobacco in a training AAT in combination with CBT will have better abstinence rates compared to those who receive placebo AAT training with CBT.

This AAT condition is a no contingency continued assessment version (50% approach-cigarettes, 50% avoid cigarettes).

To evaluate if retraining automatic approach tendencies towards smoking stimuli, in combination with CBT, enhances an adolescent's ability to quit smoking following 4 weeks of treatment for smoking cessation.

Inclusion Criteria: Inclusion Criteria: Between ages 13-18 years Able to read and write in English. Smokers: Smoking 5 or more cigarettes daily for at least 6 months; Baseline urine cotinine levels > 500 ng/ml Nonsmokers: Never smokers; Baseline urine cotinine levels < 50 ng/ml Exclusion Criteria: Current criteria for dependence on another psychoactive substance Current diagnosis of psychosis, major depression or panic disorder Regular use of any psychoactive drugs including anxiolytics and antidepressants unless the medication has been taken consistently for 2 months, is currently being monitored by a physician, and the condition for which the medication is taken is considered to be stable Pregnant or lactating girls, based on self report.