Record This pilot study conducted a preliminary examination of whether Cognitive Bias Changes (CBM) a computerized task to retrain cognitive-approach biases towards smoking stimuli (1) changed approach bias for smoking cigarettes and (2) improved smoking cessation outcomes in adolescent smokers. for smoking and neutral stimuli) training in the Netherlands (= 42) and the United States (= 18). Results While we did not observe changes in action tendencies related to CBM adolescents with higher smoking approach biases at baseline experienced greater decreases in approach biases at follow up compared to adolescents with smoking avoidance biases no matter treatment condition (= 0.01). Intent-to-treat (ITT) analyses showed that CBM when compared with sham trended toward higher end-of-treatment biochemically-confirmed seven-day point prevalence abstinence (17.2% vs. 3.2% = 0.071). ITT analysis also showed MK591 that no matter treatment condition cotinine level (= 0.045) and average quantity of cigarette smoked (≤ 0.001) significantly decreased over the course of treatment. Conclusions The findings from this pilot study suggests that re-training approach biases toward smoking cigarettes shows promise MK591 for smoking cessation among adolescent smokers. Long term study should utilize larger samples and improved variation between CBM and sham conditions and examine mechanisms underlying the CBM approach. = 214) CBM in conjunction with Cognitive Behavioral Therapy (CBT) led to 13% less relapse at one-year follow up compared to the CBT only group (29). The second option getting was replicated in a larger clinical sample of adult alcohol-dependent inpatients (= 509) (28). At one-year follow-up the relapse rates in the training group compared to the control group showed a 10% reduction in relapse rates. This effect was moderated by a switch in the approach-tendencies with individuals with stronger alcohol bias showing greater treatment effect. While CBM shows promise in alcohol treatment its effect on additional substances remains to be established (for a review see 31). A recent pilot study offered CBM via online methods to 257 adult smokers and found that the CBM relative to the control condition yielded reductions in cigarette use cigarette dependence and compulsive travel to smoke cigarettes (32). The main aims of this pilot study were to assess whether CBM can re-train approach bias toward smoking and to determine if CBM when offered in addition to Cognitive Behavioral Therapy (CBT) raises smoking cessation rates among adolescent smokers. Improving interventions for adolescent smokers is vital given that currently existing psychosocial interventions such as CBT alone have not been shown to be particularly effective (33). Importantly CBT and CBM target different processes which may be particularly useful; CBM targets automatic processes and CBT focuses on purposeful processes that involve paying attention to a specific cue and control the cue to either discard irrelevant information or store and retrieve info related to the cues (34). We hypothesized that adolescents who received CBT plus CBM would (1) have decreases in their approach bias to smoking-related stimuli and (2) accomplish greater smoking cessation rates at end of treatment (EOT) than adolescents who received CBT in addition to a sham teaching (control condition). Our secondary goals were to explore mechanism of switch and changes in smoking behaviors at Dpp4 EOT. CBM has shown to be more effective among those who have an approach bias MK591 to substance-related stimuli prior to treatment (28) so we assessed whether CBM would have a differential effect on adolescents having a smoking approach bias than a smoking avoidance at baseline. We hypothesized that adolescents with an approach bias toward smoking stimuli would display greater decreases in approach bias toward smoking-related stimuli and would more likely to be abstinent than those with an avoidance bias. We also explored additional smoking results: (1) seven-day point prevalence (PP) abstinence at three-month MK591 follow-up (2) quantity of days abstinent during treatment (3) changes in self-reported quantity of smoking cigarettes smoked seven days prior to baseline and seven days prior to EOT and (4) changes in cotinine levels between baseline and EOT. METHODS MK591 Procedures Participants were recruited from preparatory middle-level applied education MK591 (VMBO) middle-level applied education (MBO) and vocational teaching high universities in the NL (Amsterdam and Haarlem) and general public high schools in the USA (Connecticut) to.