Smoking Cessation for People Living With HIV/AIDS

NCT ID: NCT01965405

Last Updated: 2021-07-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

165 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-08-31

Study Completion Date

2021-12-31

Brief Summary

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In this proposed study with People Living with HIV/AIDS (PLWHA), we will use a stepped care model called a Sequential Multiple Assignment Randomized Trial (SMART) to examine the efficacy of low- and high-intensity smoking cessation treatments for nicotine dependent PLWHA that incorporate the current standard of care and prize-based contingency management. Intervention will be administered in a community-based HIV integrated care clinic in downtown Detroit, which has the highest prevalence rates of HIV/AIDS and smoking in Michigan. Phase 1 will last 4 weeks, and will involve brief intervention to help participants stop smoking. For phase 2, participants will be assigned to different study arms depending on whether they are Responders (reduced their smoking) or Non-responders (continued to smoke).

1. Phase 1: We hypothesize that brief high-magnitude prize contingency management will result in greater reduction in smoking than standard of care alone.
2. Phase 2a: We hypothesize that non-responders who are assigned to contingency management will be more likely to reduce their smoking throughout treatment and to abstain from smoking at all follow-up points.
3. Phase 2b: We hypothesize that responders who are assigned to monitoring and low-magnitude prize contingency management will be more likely to maintain their reduced or abstinent smoking status at all follow-up time-points.

Detailed Description

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All research related activities will take place at the Tolan Park Medical Building located at 3901 Chrysler Service Dr, Detroit, 48201.

Participants in Phase 1 will be randomized to one of two brief interventions based on standard of care guidelines (SoC): A) brief counseling and bupropion (SoC); or B) SoC plus brief high-magnitude prize CM (HM-CM). At the end of Phase 1, participants will be classified as responders or non-responders on the basis of smoking reduction/abstinence. All participants will continue to receive bupropion. Non-responders will enter Phase 2a and be randomly assigned to: A) continued counseling and monitoring support to quit smoking (MS); or B) MS plus prize CM for abstinence (MS+CM). Phase 1 responders will be entered into Phase 2b and randomly assigned to: A) no additional treatment (NAT); or B) Continued monitoring and low intensity prize CM (LI-CM). The primary dependent variables will include cotinine and carbon monoxide (CO) levels, and longest duration of abstinence from cigarettes. Seven-day point prevalence will be used to assess outcome at post-treatment, 6-month and 12-month follow-up points.

Participants will be paid $35 for intake and $25 for each follow-up interview, which will occur at post-phase 1, post-phase 2, and 6-months and 12-months after treatment initiation. Some assessments as well as treatment sessions will be recorded to ensure data quality.

Conditions

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HIV AIDS Nicotine Dependence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase 1: Standard of Care (A)

Brief counseling and bupropion

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Brief Counseling

Intervention Type BEHAVIORAL

Participants are provided with brief counseling for smoking cessation.

Phase 1: Standard of Care (B)

Brief counseling, bupropion, and brief high-magnitude prize contingency management.

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Brief Counseling

Intervention Type BEHAVIORAL

Participants are provided with brief counseling for smoking cessation.

High-magnitude prize contingency management

Intervention Type BEHAVIORAL

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Phase 2a Non-Responders (A)

Bupropion, continued counseling, monitored support to quit smoking.

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Brief Counseling

Intervention Type BEHAVIORAL

Participants are provided with brief counseling for smoking cessation.

Monitored support to quit smoking

Intervention Type BEHAVIORAL

Brief supportive sessions and monitoring of smoking cessation efforts.

Phase 2a: Non-Responders (B)

Bupropion, monitored support to quit smoking, prize contingency management for abstinence.

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Monitored support to quit smoking

Intervention Type BEHAVIORAL

Brief supportive sessions and monitoring of smoking cessation efforts.

Prize contingency management for abstinence

Intervention Type BEHAVIORAL

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Phase 2b: Responders (A)

Bupropion, no additional treatment.

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

No additional treatment

Intervention Type BEHAVIORAL

No additional treatment will be given.

Phase 2b: Responders (B)

Bupropion, continued monitoring and low intensity prize contingency management.

Group Type EXPERIMENTAL

Bupropion

Intervention Type DRUG

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Monitored support to quit smoking

Intervention Type BEHAVIORAL

Brief supportive sessions and monitoring of smoking cessation efforts.

Low intensity prize contingency management

Intervention Type BEHAVIORAL

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Interventions

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Bupropion

Participant will receive a prescription for Bupropion hydrochloride and will self-administer according to dosage instructions from the study psychiatrist.

Intervention Type DRUG

Brief Counseling

Participants are provided with brief counseling for smoking cessation.

Intervention Type BEHAVIORAL

High-magnitude prize contingency management

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Intervention Type BEHAVIORAL

Monitored support to quit smoking

Brief supportive sessions and monitoring of smoking cessation efforts.

Intervention Type BEHAVIORAL

No additional treatment

No additional treatment will be given.

Intervention Type BEHAVIORAL

Prize contingency management for abstinence

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Intervention Type BEHAVIORAL

Low intensity prize contingency management

Prize based contingency management condition in which participants have the chance to win incentives (prizes) when they provide biological test results (expired carbon monoxide and cotinine) that are negative for recent smoking.

Intervention Type BEHAVIORAL

Other Intervention Names

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Bupropion hydrochloride Wellbutrin Zyban

Eligibility Criteria

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Inclusion Criteria

1. Age 18 years or older
2. Able to read and understand English
3. Smoke more than 10 cigarettes/day
4. Patient enrolled in the HIV clinic with HIV or AIDS diagnosis

Exclusion Criteria

1. Are actively suicidal or have uncontrolled manic or psychotic symptoms requiring immediate care
2. Are in recovery for pathological gambling (PG)
3. Have contraindications for bupropion treatment (e.g., presence of epilepsy or other seizure disorder, use of monoamine oxidase inhibitors or other antidepressants, presence of eating disorders or very low weight)
4. Are already participating in other smoking cessation interventions.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Wayne State University

OTHER

Sponsor Role lead

Responsible Party

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David Ledgerwood

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David Ledgerwood, PhD

Role: PRINCIPAL_INVESTIGATOR

Wayne State University

Locations

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Tolan Park Medical Building

Detroit, Michigan, United States

Site Status

Countries

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United States

References

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Ledgerwood DM, Lundahl LH, Greenwald MK, Cohn J, Arfken CL. Prize-Based Incentives for Smoking Cessation Among People With HIV: A Sequential Multiple Assignment Randomized Trial. Nicotine Tob Res. 2025 Apr 22;27(5):893-902. doi: 10.1093/ntr/ntae243.

Reference Type DERIVED
PMID: 39404754 (View on PubMed)

Other Identifiers

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1R01DA034537-01A1

Identifier Type: NIH

Identifier Source: secondary_id

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1R01DA034537-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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