Treating Smokeless Tobacco Use in Rural Veterans

NCT ID: NCT02994082

Last Updated: 2019-07-24

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

123 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2020-05-31

Brief Summary

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This is a pilot study designed in an effort to develop and improve access to effective treatments for tobacco use in rural Veterans using a tailored intervention approach. Specifically, we will evaluate a combined behavioral and pharmacological smokeless tobacco cessation which concomitantly addresses comorbid issues commonly experienced by rural tobacco users including elevated depressive symptoms, risky alcohol use, and concerns about weight gain. The objectives are to:

1. Evaluate the feasibility of an individually-tailored telephone intervention for rural smokeless tobacco users
2. Examine the impact of the intervention on treatment utilization, patient satisfaction, and smokeless tobacco cessation.

Detailed Description

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Conditions

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Smokeless Tobacco Nicotine Dependence

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

The tailored behavioral intervention includes both behavioral and pharmacological components. The behavioral component will consist of six sessions of cognitive behavioral therapy and coping skills training delivered over the telephone. In addition, participants will be screened for conditions commonly associated with tobacco use (depressive symptoms, risky alcohol use, weight concerns) and offered supplementary behavioral treatment modules to address these issues. Participants will also be offered pharmacotherapy for tobacco cessation, with decisions regarding specific medication(s) based on patients' medical history, contraindications, prior experiences, and preferences.

Group Type EXPERIMENTAL

Tailored behavioral intervention

Intervention Type BEHAVIORAL

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

Behavioral activation for elevated depressive symptoms

Intervention Type BEHAVIORAL

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

Post-cessation weight gain management

Intervention Type BEHAVIORAL

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

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.

Nicotine replacement therapy - transdermal nicotine patch

Intervention Type DRUG

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

Nicotine replacement therapy - nicotine lozenge

Intervention Type DRUG

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

Nicotine replacement therapy - nicotine gum

Intervention Type DRUG

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

Bupropion sustained release

Intervention Type DRUG

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

Varenicline

Intervention Type DRUG

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

Combination nicotine replacement therapy

Intervention Type DRUG

Medication selection will be based on individual participant preferences, medical history, and contraindications. Possible combinations include nicotine patch + nicotine lozenge and nicotine patch + nicotine gum.

Combination nicotine replacement therapy + bupropion

Intervention Type DRUG

Medication selection will be based on individual participant preferences, medical history, and contraindications. Possible combinations include nicotine patch + bupropion, nicotine gum + bupropion, and nicotine lozenge + bupropion.

Facilitated tobacco quit line referral

Participants assigned to this condition will receive information about the VA telephone tobacco quit line and educational materials and encouraged to enroll in treatment. In addition, they will be given information regarding available medications for smoking cessation and encouraged to contact their primary care provider to discuss their options.

Group Type ACTIVE_COMPARATOR

Tobacco quit line

Intervention Type BEHAVIORAL

Referral to the Department of Veterans Affairs tobacco telephone quit line.

Educational materials

Intervention Type BEHAVIORAL

Information regarding the VA tobacco quit line and associated treatment services, self-help materials for tobacco cessation, and information about tobacco cessation medications available in the VA,

Interventions

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Tailored behavioral intervention

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

Intervention Type BEHAVIORAL

Behavioral activation for elevated depressive symptoms

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

Intervention Type BEHAVIORAL

Post-cessation weight gain management

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

Intervention Type BEHAVIORAL

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

Nicotine replacement therapy - transdermal nicotine patch

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

Intervention Type DRUG

Nicotine replacement therapy - nicotine lozenge

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

Intervention Type DRUG

Nicotine replacement therapy - nicotine gum

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

Intervention Type DRUG

Bupropion sustained release

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

Intervention Type DRUG

Varenicline

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

Intervention Type DRUG

Combination nicotine replacement therapy

Medication selection will be based on individual participant preferences, medical history, and contraindications. Possible combinations include nicotine patch + nicotine lozenge and nicotine patch + nicotine gum.

Intervention Type DRUG

Combination nicotine replacement therapy + bupropion

Medication selection will be based on individual participant preferences, medical history, and contraindications. Possible combinations include nicotine patch + bupropion, nicotine gum + bupropion, and nicotine lozenge + bupropion.

Intervention Type DRUG

Tobacco quit line

Referral to the Department of Veterans Affairs tobacco telephone quit line.

Intervention Type BEHAVIORAL

Educational materials

Information regarding the VA tobacco quit line and associated treatment services, self-help materials for tobacco cessation, and information about tobacco cessation medications available in the VA,

Intervention Type BEHAVIORAL

Other Intervention Names

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Nicotine patch Nicotine lozenge Nicotine gum Zyban Chantix Medication selection will be based on individual participant preferences, medical history, and contraindications.

Eligibility Criteria

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Inclusion Criteria

1. Use smokeless tobacco on a daily basis
2. Be willing to make a quit attempt in the next 30 days
3. Reside in a rural location
4. Receiving care through the Iowa City VA Health Care System or an affiliated community-based outpatient clinic
5. Able to provide informed consent
6. Telephone access
7. Stable residence

Exclusion Criteria

1. Planning to move in the next 12 months
2. Terminal illness
3. Unstable psychiatric disorder
4. Incarcerated
5. Institutionalized
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Iowa City VA Health Care System

FED

Sponsor Role collaborator

Mark Vander Weg

FED

Sponsor Role lead

Responsible Party

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Mark Vander Weg

Reserach Specialist

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Mark W. Vander Weg, PhD

Role: PRINCIPAL_INVESTIGATOR

Iowa City VA Health Care System

Locations

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Iowa City VA Healthcare System

Iowa City, Iowa, United States

Site Status

Countries

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United States

Other Identifiers

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201611737

Identifier Type: -

Identifier Source: org_study_id

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