Table 2 Module content for integrated intervention

M1: Introduction

• Introduction to the intervention and website

• Psychoeducation about the links between gambling and cigarette smoking, including a rationale for working on both in treatment together

• Motivational enhancement (i.e. identifying reasons for change, and pros and cons of gambling/not gambling, and smoking/not smoking)

• Psychoeducational fact sheet on nicotine replacement therapy (NRT), including a strong recommendation for using NRT during the intervention

• Self-monitoring gambling and smoking behaviours, including frequency of co-occurrence

M2: Goal setting

• Determine personal goals related to gambling and smoking (i.e. abstinence versus harm reduction)

• Develop SMART (specific, measurable, achievable, realistic, and timely) goals for gambling and smoking reduction

M3: Risk situations

• Resisting gambling in specific situations (e.g. situations involving negative emotions)

• Developing personal strategies to reduce/abstain from harmful gambling and to control access to money

• Introduce need for pleasurable activity scheduling (i.e. behavioural activation)

• SMART goal setting for pleasurable, low-risk, and healthy activities (e.g. activities that are incompatible with gambling and smoking)

M4: Identifying triggers

• Strategies for avoiding triggering situations related to smoking

• Identify strategies for refusing smoking and gambling

M5: Unhelpful thinking

• Review common thinking errors related to gambling (or “gambling traps”) and smoking

• Psychoeducation about games of chance

• Identify how misperceptions about gambling odds impact one’s inner dialogue or thoughts

• Psychoeducation about thinking traps related to smoking

M6: Cravings

• Psychoeducation about craving

• Introduce self-monitoring of craving

• New ways to effectively cope with cravings (e.g. distraction, urge surfing, and recalling the negative outcomes of gambling)

• Identifying the similarities and differences between gambling and smoking cravings

M7: Dealing with slips

• Define a “slip” versus a full-blown relapse

• Introduce ways to cope with slip in meeting gambling and smoking goals

• Introduce relapse prevention planning

• Create personalized relapse prevention plan

• Identify three coping strategies for preventing gambling and smoking