Tailored Tobacco Quitline for Rural Veterans

NCT ID: NCT01592695

Last Updated: 2019-08-02

Study Results

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Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-30

Study Completion Date

2013-06-30

Brief Summary

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The proposed work is designed to help increase access to tobacco cessation services among rural veterans and to develop more effective treatment services that better address comorbid issues commonly experienced by rural smokers. The objectives are:

1. Study the feasibility of an individually-tailored telephone intervention for rural smokers.
2. Examine the impact of the intervention on tobacco use outcomes.
3. Evaluate the effect of the intervention on issues commonly experienced by rural smokers including depressive symptoms, alcohol use, and weight gain.

Detailed Description

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Tobacco use remains the leading preventable cause of morbidity and mortality in our society. Results from epidemiologic studies indicate that tobacco use is especially elevated among those living in rural areas. Although interventions exist that are both effective and cost-effective, few rural smokers utilize them during any given quit attempt. A lack of local treatment resources, the travel distance required to obtain treatment, and a reduced tendency to visit primary care on a regular basis all appear to contribute to the lower levels of treatment for nicotine dependence in rural smokers.

Smokers frequently experience conditions and concerns that adversely impact their ability to quit smoking. Depression and risky alcohol use, both of which are prevalent among smokers, reduce the likelihood of successfully quitting smoking. Concern about gaining weight, a common consequence of quitting smoking, is also frequently cited by smokers as an important barrier to quitting. Therefore, in order to be most effective, tobacco cessation interventions will need to address these important issues. Presently, treatment for nicotine dependence, risky alcohol use, depression, and weight management is typically delivered separately and without optimal integration among providers, an approach which only serves to fragment care and increase the number of required visits, further reduce rural smokers' access to care.

In an effort to address these barriers, the current study will evaluate a telephone intervention for tobacco use that also addresses issues related to risky alcohol use, depressed mood, and postcessation weight gain based on each individual smoker's needs. Results will provide valuable information regarding the potential to more widely implement an individually-tailored telephone intervention for rural smokers.

Conditions

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Cigarette Smoking

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Tailored Intervention Group

Participants will receive a combined behavioral and pharmacological intervention. The behavioral component will consist of a six-session cognitive behavioral telephone intervention combined with supplemental treatment modules to address common issues associated with cigarette smoking.

Group Type EXPERIMENTAL

Nicotine replacement therapy - transdermal nicotine patch

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications.

Tailored behavioral intervention

Intervention Type BEHAVIORAL

Participants will receive a standard six session cognitive behavioral intervention for smoking cessation combined with supplemental treatment modules based on individual need and preference.

Nicotine replacement therapy - nicotine gum

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Nicotine replacement therapy - nicotine lozenge

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Bupropion Sustained Release

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Varenicline

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + nicotine gum

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + nicotine lozenge

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + bupropion

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Alcohol use risk reduction

Intervention Type BEHAVIORAL

Participants engaging in risky alcohol use may receive this six-session telephone-based behavioral intervention for reducing alcohol use.

Behavioral activation for the treatment of depression

Intervention Type BEHAVIORAL

Participants with elevated depressive symptoms may receive this six-session telephone-based behavioral activation intervention.

Behavioral management of post-cessation weight gain

Intervention Type BEHAVIORAL

Participants with concerns about gaining weight after quitting smoking may receive this six-session telephone-based behavioral self-management intervention designed to help attenuate post-cessation weight gain.

Enhanced Standard of Care Group

Participants assigned to the enhanced standard of care condition will receive referral to their state tobacco quit line along with pharmacotherapy to assist with smoking cessation.

Group Type ACTIVE_COMPARATOR

Nicotine replacement therapy - transdermal nicotine patch

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications.

Tobacco quit line referral

Intervention Type BEHAVIORAL

Participants assigned to this condition will receive a referral to their state tobacco quit line. The specific behavioral treatment that is provided will differ slightly depending upon the services available through the participant's state of residence.

Nicotine replacement therapy - nicotine gum

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Nicotine replacement therapy - nicotine lozenge

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Bupropion Sustained Release

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Varenicline

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + nicotine gum

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + nicotine lozenge

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Combination pharmacotherapy - transdermal nicotine patch + bupropion

Intervention Type DRUG

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Interventions

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Nicotine replacement therapy - transdermal nicotine patch

Medication selection will be determined based on individual participant preferences, medical history, and contraindications.

Intervention Type DRUG

Tailored behavioral intervention

Participants will receive a standard six session cognitive behavioral intervention for smoking cessation combined with supplemental treatment modules based on individual need and preference.

Intervention Type BEHAVIORAL

Tobacco quit line referral

Participants assigned to this condition will receive a referral to their state tobacco quit line. The specific behavioral treatment that is provided will differ slightly depending upon the services available through the participant's state of residence.

Intervention Type BEHAVIORAL

Nicotine replacement therapy - nicotine gum

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Nicotine replacement therapy - nicotine lozenge

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Bupropion Sustained Release

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Varenicline

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Combination pharmacotherapy - transdermal nicotine patch + nicotine gum

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Combination pharmacotherapy - transdermal nicotine patch + nicotine lozenge

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Combination pharmacotherapy - transdermal nicotine patch + bupropion

Medication selection will be determined based on individual participant preferences, medical history, and contraindications

Intervention Type DRUG

Alcohol use risk reduction

Participants engaging in risky alcohol use may receive this six-session telephone-based behavioral intervention for reducing alcohol use.

Intervention Type BEHAVIORAL

Behavioral activation for the treatment of depression

Participants with elevated depressive symptoms may receive this six-session telephone-based behavioral activation intervention.

Intervention Type BEHAVIORAL

Behavioral management of post-cessation weight gain

Participants with concerns about gaining weight after quitting smoking may receive this six-session telephone-based behavioral self-management intervention designed to help attenuate post-cessation weight gain.

Intervention Type BEHAVIORAL

Other Intervention Names

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Zyban Chantix Risky alcohol use Harm reduction Depression Weight management

Eligibility Criteria

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Inclusion Criteria

* Being a veteran
* 18 + years of age
* Smoke cigarettes on at least a daily basis
* Receive primary care from the Iowa City VAMC or Coralville Clinic
* Live in a non-metropolitan area (based on RUCA codes)
* Be willing to make a quit attempt in the next 30 days
* Be capable of providing informed consent
* Have access to a telephone (land line or cell phone)
* Have a stable residence

Exclusion Criteria

* Planning to move within the next 12 months
* Presence of a terminal illness
* Pregnancy
* Unstable psychiatric disorder (e.g., acute psychosis)
* Currently pregnant
* Incarcerated
* Institutionalized
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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US Department of Veterans Affairs

FED

Sponsor Role collaborator

Iowa City Veterans Affairs Medical Center

FED

Sponsor Role lead

Responsible Party

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Mark Vander Weg

Research Specialist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mark VanderWeg, PhD

Role: PRINCIPAL_INVESTIGATOR

VRHRC-CR

Locations

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Iowa City VA Health Care System

Iowa City, Iowa, United States

Site Status

Countries

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United States

References

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Vander Weg MW, Cozad AJ, Howren MB, Cretzmeyer M, Scherubel M, Turvey C, Grant KM, Abrams TE, Katz DA. An individually-tailored smoking cessation intervention for rural Veterans: a pilot randomized trial. BMC Public Health. 2016 Aug 17;16(1):811. doi: 10.1186/s12889-016-3493-z.

Reference Type RESULT
PMID: 27535024 (View on PubMed)

Livingstone-Banks J, Fanshawe TR, Thomas KH, Theodoulou A, Hajizadeh A, Hartman L, Lindson N. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2023 May 5;5(5):CD006103. doi: 10.1002/14651858.CD006103.pub8.

Reference Type DERIVED
PMID: 37142273 (View on PubMed)

Other Identifiers

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201203712

Identifier Type: -

Identifier Source: org_study_id

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