Trial Outcomes & Findings for A Pilot Randomized Controlled Trial of Financial Incentives, Text Messaging, and Usual Care for Homeless Smokers (NCT NCT02565381)

NCT ID: NCT02565381

Last Updated: 2017-07-14

Results Overview

The primary outcome is a repeated-measures assessment of smoking abstinence, defined as an exhaled carbon monoxide \<8ppm and assessed 14 times over the 8-week study period (3 times/week for the first 2 weeks, 2 times/week for the next 2 weeks, and once every week for the last 4 weeks)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

83 participants

Primary outcome timeframe

Point-in-time abstinence assessed in a repeated fashion 14 times over the 8-week study period

Results posted on

2017-07-14

Participant Flow

Some participants (N=8) enrolled in the study but did not return for randomization.

Participant milestones

Participant milestones
Measure
Control (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Financial Rewards (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Text Messaging (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Overall Study
STARTED
25
25
25
Overall Study
COMPLETED
24
25
24
Overall Study
NOT COMPLETED
1
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Control (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Financial Rewards (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Text Messaging (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Overall Study
Lost to Follow-up
1
0
1

Baseline Characteristics

A Pilot Randomized Controlled Trial of Financial Incentives, Text Messaging, and Usual Care for Homeless Smokers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Total
n=75 Participants
Total of all reporting groups
Age, Continuous
45.1 years
STANDARD_DEVIATION 9.6 • n=5 Participants
48.1 years
STANDARD_DEVIATION 8.5 • n=7 Participants
46.1 years
STANDARD_DEVIATION 9.2 • n=5 Participants
46.4 years
STANDARD_DEVIATION 9.1 • n=4 Participants
Sex: Female, Male
Female
14 Participants
n=5 Participants
12 Participants
n=7 Participants
15 Participants
n=5 Participants
41 Participants
n=4 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
13 Participants
n=7 Participants
10 Participants
n=5 Participants
34 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=5 Participants
6 Participants
n=7 Participants
2 Participants
n=5 Participants
13 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
20 Participants
n=5 Participants
19 Participants
n=7 Participants
23 Participants
n=5 Participants
62 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
3 Participants
n=5 Participants
3 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
9 Participants
n=5 Participants
11 Participants
n=7 Participants
11 Participants
n=5 Participants
31 Participants
n=4 Participants
Race (NIH/OMB)
White
10 Participants
n=5 Participants
11 Participants
n=7 Participants
10 Participants
n=5 Participants
31 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants
n=5 Participants
3 Participants
n=7 Participants
1 Participants
n=5 Participants
10 Participants
n=4 Participants
Region of Enrollment
United States
25 Participants
n=5 Participants
25 Participants
n=7 Participants
25 Participants
n=5 Participants
75 Participants
n=4 Participants
Fagerstrom Test for Nicotine Dependence
5.1 units on a scale
STANDARD_DEVIATION 1.8 • n=5 Participants
5.1 units on a scale
STANDARD_DEVIATION 1.9 • n=7 Participants
4.9 units on a scale
STANDARD_DEVIATION 2.0 • n=5 Participants
5.0 units on a scale
STANDARD_DEVIATION 1.9 • n=4 Participants
Quitting confidence
6.8 units on a scale
STANDARD_DEVIATION 2.2 • n=5 Participants
6.4 units on a scale
STANDARD_DEVIATION 2.5 • n=7 Participants
5.9 units on a scale
STANDARD_DEVIATION 2.4 • n=5 Participants
6.4 units on a scale
STANDARD_DEVIATION 2.4 • n=4 Participants
Quitting importance
8.8 units on a scale
STANDARD_DEVIATION 1.5 • n=5 Participants
8.5 units on a scale
STANDARD_DEVIATION 2.1 • n=7 Participants
8.9 units on a scale
STANDARD_DEVIATION 1.6 • n=5 Participants
8.8 units on a scale
STANDARD_DEVIATION 1.7 • n=4 Participants

PRIMARY outcome

Timeframe: Point-in-time abstinence assessed in a repeated fashion 14 times over the 8-week study period

Population: Participants with missing data at a given time point were assumed non-abstinent at that time point.

The primary outcome is a repeated-measures assessment of smoking abstinence, defined as an exhaled carbon monoxide \<8ppm and assessed 14 times over the 8-week study period (3 times/week for the first 2 weeks, 2 times/week for the next 2 weeks, and once every week for the last 4 weeks)

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 3
10 Participants
3 Participants
3 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 5
9 Participants
0 Participants
1 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 7
15 Participants
4 Participants
3 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 10
15 Participants
4 Participants
2 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 12
17 Participants
5 Participants
4 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 14
15 Participants
4 Participants
4 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 17
13 Participants
3 Participants
4 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 21
14 Participants
2 Participants
3 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 24
17 Participants
2 Participants
5 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 28
12 Participants
4 Participants
2 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 35
8 Participants
4 Participants
3 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 42
11 Participants
4 Participants
2 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 49
11 Participants
3 Participants
1 Participants
Number of Participants With Biochemically-verified Smoking Abstinence, Assessed 14 Times Over 8 Weeks
Day 56
12 Participants
2 Participants
4 Participants

SECONDARY outcome

Timeframe: 8 weeks

Population: Participants with missing data at a given time point were assumed non-abstinent at that time point.

Percentage of 14 assessment visits at which a participant is abstinent of smoking, defined as an exhaled carbon monoxide level \<8ppm.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Percentage of Visits Abstinent of Smoking
51.1 percentage of visits
Standard Deviation 32.8
12.6 percentage of visits
Standard Deviation 22.1
11.7 percentage of visits
Standard Deviation 21.9

SECONDARY outcome

Timeframe: 8 weeks

Point-prevalence smoking abstinence, defined as an exhaled carbon monoxide level \<8ppm, at the 14th (final) study visit.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Smoking Abstinence at End of Study
12 Participants
2 Participants
4 Participants

SECONDARY outcome

Timeframe: Once per week for 8 weeks

Population: Participants with missing data at a given time point are excluded from calculation of mean changes in cigarette consumption for that time point.

Changes in the average number of cigarettes per day relative to baseline, defined by self-report and repeatedly assessed at the 8 assessment visits occurring on Fridays.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Change in Cigarette Consumption
Week 8
-7.9 Cigarettes per day
Standard Deviation 5.5
-8.7 Cigarettes per day
Standard Deviation 5.9
-5.4 Cigarettes per day
Standard Deviation 3.7
Change in Cigarette Consumption
Week 1
-8.5 Cigarettes per day
Standard Deviation 6.0
-5.3 Cigarettes per day
Standard Deviation 6.1
-6.0 Cigarettes per day
Standard Deviation 7.2
Change in Cigarette Consumption
Week 2
-8.6 Cigarettes per day
Standard Deviation 6.8
-6.7 Cigarettes per day
Standard Deviation 5.8
-7.5 Cigarettes per day
Standard Deviation 6.8
Change in Cigarette Consumption
Week 3
-12.3 Cigarettes per day
Standard Deviation 10.2
-8.5 Cigarettes per day
Standard Deviation 5.4
-7.7 Cigarettes per day
Standard Deviation 7.2
Change in Cigarette Consumption
Week 4
-11.1 Cigarettes per day
Standard Deviation 6.9
-8.0 Cigarettes per day
Standard Deviation 5.6
-9.5 Cigarettes per day
Standard Deviation 7.2
Change in Cigarette Consumption
Week 5
-10.2 Cigarettes per day
Standard Deviation 7.2
-9.4 Cigarettes per day
Standard Deviation 6.4
-7.9 Cigarettes per day
Standard Deviation 7.0
Change in Cigarette Consumption
Week 6
-10.4 Cigarettes per day
Standard Deviation 6.7
-6.2 Cigarettes per day
Standard Deviation 4.2
-5.4 Cigarettes per day
Standard Deviation 5.2
Change in Cigarette Consumption
Week 7
-10.1 Cigarettes per day
Standard Deviation 7.2
-8.6 Cigarettes per day
Standard Deviation 6.4
-8.1 Cigarettes per day
Standard Deviation 8.0

SECONDARY outcome

Timeframe: 4 weeks and 8 weeks

Population: Participants with missing data at a particular time point are excluded from calculation of mean change in ASI scores at that time point.

Past-month drug use severity (score range 0-1), past-month alcohol use severity (score range 0-1), and past-month psychiatric severity (0-1) were each assessed with the Addiction Severity Index (ASI) - 5th Edition, at baseline and at the 10th and 14th study visits. For each ASI measure, higher scores represent greater drug, alcohol, or psychiatric severity. Changes in ASI scores between baseline and 4 or 8 weeks can range from -1 to +1. When interpreting changes in scores, negative values indicate decreases in scores from baseline to 4 or 8 weeks, and positive values indicate increases in scores from baseline to 4 or 8 weeks.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Change in Behavioral Health
ASI alcohol 8 wk change
0.01 units on a scale
Standard Deviation 0.13
-0.01 units on a scale
Standard Deviation 0.13
-0.04 units on a scale
Standard Deviation 0.14
Change in Behavioral Health
ASI alcohol 4 wk change
-0.04 units on a scale
Standard Deviation 0.10
-0.02 units on a scale
Standard Deviation 0.12
-0.09 units on a scale
Standard Deviation 0.13
Change in Behavioral Health
ASI drug 4 wk change
-0.04 units on a scale
Standard Deviation 0.07
-0.02 units on a scale
Standard Deviation 0.08
-0.03 units on a scale
Standard Deviation 0.09
Change in Behavioral Health
ASI drug 8 wk change
-0.01 units on a scale
Standard Deviation 0.08
-0.02 units on a scale
Standard Deviation 0.08
0 units on a scale
Standard Deviation 0.09
Change in Behavioral Health
ASI psychiatric 4 wk change
-0.04 units on a scale
Standard Deviation 0.13
-0.06 units on a scale
Standard Deviation 0.22
-0.01 units on a scale
Standard Deviation 0.20
Change in Behavioral Health
ASI psychiatric 8 wk change
0.08 units on a scale
Standard Deviation 0.17
-0.04 units on a scale
Standard Deviation 0.21
-0.04 units on a scale
Standard Deviation 0.16

SECONDARY outcome

Timeframe: 8 weeks

Percentage of 14 assessment visits attended.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Study Visit Attendance
71.1 percentage of visits
Standard Deviation 24.3
65.4 percentage of visits
Standard Deviation 32.2
65.7 percentage of visits
Standard Deviation 27.0

SECONDARY outcome

Timeframe: 8 weeks

Percentage of 8 counseling visits attended.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Counseling Visit Attendance
10.5 percentage of visits
Standard Deviation 12.8
17.0 percentage of visits
Standard Deviation 21.3
17.0 percentage of visits
Standard Deviation 21.0

SECONDARY outcome

Timeframe: 8 weeks

Population: Participants with missing data at a given time point were excluded from calculation of mean past-week patch use at that time point.

Days of nicotine replacement therapy use in past week, repeatedly measured at the 8 assessment visits occurring on Fridays.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=24 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Nicotine Patch Use
Week 1
4.1 Days
Standard Deviation 2.6
3.7 Days
Standard Deviation 2.7
4.5 Days
Standard Deviation 2.9
Nicotine Patch Use
Week 2
4.5 Days
Standard Deviation 2.6
4.9 Days
Standard Deviation 2.8
4.5 Days
Standard Deviation 2.9
Nicotine Patch Use
Week 3
4.9 Days
Standard Deviation 2.2
4.4 Days
Standard Deviation 2.9
4.9 Days
Standard Deviation 2.9
Nicotine Patch Use
Week 4
3.6 Days
Standard Deviation 2.8
4.3 Days
Standard Deviation 3.0
4.4 Days
Standard Deviation 2.8
Nicotine Patch Use
Week 5
4.6 Days
Standard Deviation 2.8
4.4 Days
Standard Deviation 2.7
4.9 Days
Standard Deviation 2.5
Nicotine Patch Use
Week 6
4.0 Days
Standard Deviation 3.0
3.5 Days
Standard Deviation 2.8
4.1 Days
Standard Deviation 2.7
Nicotine Patch Use
Week 7
4.6 Days
Standard Deviation 2.5
4.3 Days
Standard Deviation 2.8
3.8 Days
Standard Deviation 2.6
Nicotine Patch Use
Week 8
3.9 Days
Standard Deviation 2.9
3.6 Days
Standard Deviation 3.1
2.7 Days
Standard Deviation 2.9

OTHER_PRE_SPECIFIED outcome

Timeframe: Until target number of participants is reached; anticipate ~6 months

Total time to recruit, enroll, and randomize 75 study participants.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Recruitment Time
6 months
6 months
6 months

OTHER_PRE_SPECIFIED outcome

Timeframe: 8 weeks

Percentage of participants who still have their mobile phone at the end of the study.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Mobile Phone Retention
15 Participants
13 Participants
10 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: 8 weeks

Text messaging group only: number who enrolled in SmokefreeTXT, number who replied to query texts sent by SmokefreeTXT.

Outcome measures

Outcome measures
Measure
Financial Rewards (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Control (N=25)
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Text Messaging (N=25)
n=25 Participants
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Use of Text Messaging Program
Enrolled in SmokefreeTXT
22 Participants
Use of Text Messaging Program
Replied to texts from SmokefreeTXT
7 Participants

Adverse Events

Control (N=25)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Financial Rewards (N=25)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Text Messaging (N=25)

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Control (N=25)
n=25 participants at risk
* Transdermal nicotine patch * In-person smoking cessation counseling Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks
Financial Rewards (N=25)
n=25 participants at risk
* Transdermal nicotine patch * In-person smoking cessation counseling * Contingent financial rewards for smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Contingent financial rewards for smoking abstinence: - Escalating-value financial rewards for smoking abstinence, verified by exhaled carbon monoxide \<8ppm
Text Messaging (N=25)
n=25 participants at risk
* Transdermal nicotine patch * In-person smoking cessation counseling * Text messages to support smoking abstinence Transdermal nicotine patch: - ≥10 cigarettes per day: nicotine 21mg/24hr patch daily x 6 weeks, then nicotine 14mg/24hr patch daily x 2 weeks \- \<10 cigarettes per day: nicotine 14mg/24hr patch daily x 8 weeks In-person smoking cessation counseling: - One-on-one 15-minute counseling sessions once per week for 8 weeks Text messages to support smoking abstinence: - 1-5 text messages per day starting up to 2 weeks before the quit date and continuing until 6 weeks after the quit date, delivered by SmokefreeTXT
Gastrointestinal disorders
Nausea/vomiting
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
8.0%
2/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
Skin and subcutaneous tissue disorders
Rash at nicotine patch site
4.0%
1/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
Nervous system disorders
Dizziness
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
8.0%
2/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
General disorders
Sweating
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
8.0%
2/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
General disorders
Headache
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
4.0%
1/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
General disorders
Fatigue
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
0.00%
0/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.
4.0%
1/25 • Adverse event data were collected during the 8-week study period for each participant.
Participants were asked about adverse events at each of the 14 follow-up visits over 8 weeks.

Additional Information

Travis P. Baggett, MD, MPH (Principal Investigator)

Massachusetts General Hospital

Phone: 617-643-9314

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place