Introduction:
We report the evaluation and psychological intervention to quit smoking of a 41-year-old male with depression and Myosin Storage Myopathy (MSM) caused by a genetic mutation in MYH7. MSM is a congenital skeletal muscle disorder which the main manifestation is muscle weakness especially in limb-girdle or scapuloperoneal muscles. The MSN had caused him an important physical impairment and psychological distress.

Methods:
JG was remitted to the Smoking Cessation and Addictive Disorders Unit by his primary care physician, due to the recent detection of polyglobulia, and the cardiovascular risk associated. JG smoked an average of 15 rolled cigarettes a day, and obtained a score of 3 in the Fagerstrom Test for Cigarette Dependence (FTCD). He presented moderate depressive symptoms [score of 23 in the Beck Depression Inventory (BDI-II)]. We adapted a standardized smoking cessation cognitive-behavioral intervention, which was delivered across eight 50-min individual sessions. The principal intervention components were therapeutic contract, cigarettes self-report, information about tobacco, nicotine fading, stimulus control, strategies to prevent nicotine withdrawal symptoms, physiological feedback of cigarette consumption through CO assessment, training in relapse prevention strategies, and mood management strategies.

Results:
At the end of the intervention JG quitted smoking and remained abstinent at 3, and 6 months follow-ups. In addition, he reported a physical improvement and a reduction in depressive symptoms (from BDI-II scores of 23 at pretreatment to 10 posttreatment, and 11 at 3 and 6 months follow-ups).

Conclusions:
In this case, depressive symptoms were an important barrier to achieve tobacco abstinence, due to JG used to smoke to alleviate psychological distress related to his physical disease. This reveals the importance of addressing both smoking and depression, in order to achieve and maintain not only tobacco abstinence, but also a better physical and psychological health.

Funding:
This research was supported by the Spanish Ministry of Economy and Competitiveness (Project reference: PSI2015-66755-R) and co-financed by FEDER (European Regional Development Fund; pluri-annual plan 2014-2020).