Contingency Management to Promote Smoking Cessation: A Pilot Randomized Clinical Trial
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Health Rewards, Control.
- Who it may be relevant to
- Registry conditions: Smoking Cessation. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Adherence to medication and counseling are strong predictors of smoking cessation success. To provide these two components of care, healthcare providers typically provide people who smoke with prescriptions for cessation medications, and refer them to state-sponsored tobacco quitlines. However, most people who smoke that are referred to quitlines never actually enroll, and those who do enroll participate in very few sessions. Similarly, most people who smoke that receive prescriptions for cessation medications rarely fill or use them, even when they have no co-pay or pre-authorization requirements. To address this problem we will recruit 40 patients for a pilot 2-arm effectiveness trial. We will recruit patients from the University of Kansas Medical Center. Participants will then be randomized either to control or Health Reward. All participants will receive 12 weeks of varenicline and referrals to their state tobacco quitline (Control condition). In Health rewards arm, participants will additionally receive CM for medication (MedCM) and for counseling (CounsCM). The use of medication will be tracked using an electronic pill dispenser (Wisepill). All participants will be contacted for follow up 3, 6 and 12 weeks after starting the treatment. Feasibility data will include recruitment and retention rates. Preliminary effectiveness outcomes will include treatment engagement and cessation rates.
Detailed description
Novel approaches are needed to engage people who smoke in treatment in a way that increases their odds of quitting. Contingency management (CM) interventions provide financial incentives to participants contingent on objective evidence of behavior change and are effective in enhancing medication adherence and treatment engagement for numerous health conditions, including tobacco dependence treatment. Critical gaps, however, remain in our knowledge regarding how best to deploy CM.
The goal of this study is to evaluate the acceptability and feasibility of combined CM for engaging patients in smoking cessation treatment. Participants (N=20) will receive "CounsCM" for engaging in five quitline calls and "MedCM" for utilizing varenicline over twelve weeks. CM payments will be automated and dispensed on a daily basis using a reloadable debit card. The investigators will use surveys and structured interviews to understand strengths, weaknesses, and areas for improvement.
Interventions
- Behavioral Health Rewards
All participants will receive 12 weeks of varenicline and referrals to their state tobacco quitline. In Health rewards arm, participants will additionally receive CM for medication (MedCM) and for counseling (CounsCM). - Behavioral Control
All participants in the control group will receive 12 weeks of varenicline and referrals to their state tobacco quitline.
Primary outcome measures
- Feasibility outcomes [Time frame: Week 3 to 12]
- Proportion of quitline calls completed [Time frame: Week 12]
- Proportion of varenicline pills taken [Time frame: Week 12]
Secondary outcome measures (2)
- Proportion of patients with biochemically verified smoking abstinence [Time frame: Week 12]
- Proportion of patients with self-reported smoking abstinence [Time frame: Week 12]
Eligibility criteria
Inclusion criteria
- Smoked in the past 30 days
- Smoke at least 1 cigarette per day when they smoke
- ≥ 18 years old
- Kansas resident
- Speak/read English
- Access to a mobile phone
- Mobile phone receives text messages
- No varenicline contraindications (no acute renal impairment)
- Have no significant co-morbidity (i.e., life-threatening illness, communication barriers or altered mental status)
- Cognitively able to participate
- Physically able to participate
- Not pregnant/breastfeeding
Exclusion criteria
- Medically ineligible for varenicline
- Patient on smoking cessation medication within 2 weeks of admission date
- Patient already talked to quitline in the past 2 weeks.
- Patients participating in other quit smoking program or research study
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
United States · 1 center
- University of Kansas Medical Center — Kansas City
Identifiers
NCT: NCT07685899 · DA055779-2