Tobacco use is the primary preventable cause of cancer and premature death in the US and most smokers visit a healthcare setting each year, providing an unequaled opportunity to intervene. Yet, most smokers do not receive highly effective smoking treatment during their healthcare visits. To improve the effectiveness of smoking treatment in healthcare, this project will conduct a comparative effectiveness randomized clinical trial that compares two promising experimental smoking cessation treatments with one another and with usual care. The two experimental treatments are based on innovative methods: their components have all produced strong additive or interactive effects in prior experiments, they are designed to be part of a chronic care approach that addresses phase-specific challenges of smoking treatment (encountered when preparing to quit, quitting, and maintaining abstinence), and they were engineered for, and tested in, healthcare settings. Smokers (N=1200) from primary care clinics, who want to quit smoking, will be randomized to receive one of three treatments: 1) Abstinence-Optimized Treatment (to maximize cessation success): prequit nicotine gum, 26 weeks of combination nicotine patch + nicotine gum, intensive in-person counseling, and long-term phone counseling;2) Cost-Optimized Treatment (to maximize abstinence rates for a total cost <$500): 8 weeks of combination nicotine patch + nicotine gum, intensive in-person counseling, and long-term phone counseling;or 3) Usual Care (based on the 2008 Public Health Service Guideline for cessation treatment): 8 weeks of nicotine patch, one in-person and two phone counseling sessions. Treatments will be compared on key clinical (e.g., latency to relapse) and healthcare system (e.g., net monetary benefit) outcomes, and on mechanisms thought to produce their effects. This research will, for the first time, evaluate treatments for smoking that were developed systematically and will determine their comparative effectiveness and cost-effectiveness in real-world settings. Results will be used to construct a chronic care treatment for smoking. The proposed research could shift the paradigm for treating tobacco use to a chronic care model and advance intervention science by validating new treatment development methods.

Public Health Relevance

The proposed research will test promising smoking treatments that contain only components that have been shown to work well together and to be effective in real-world healthcare settings. These treatments could increase smoking cessation in primary care patients and thereby reduce the death and disease caused by tobacco and lead to other improved treatments by validating new treatment development methods.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
1P01CA180945-01
Application #
8655745
Study Section
Special Emphasis Panel (ZCA1-RPRB-0 (O2))
Project Start
2014-09-01
Project End
2019-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
1
Fiscal Year
2014
Total Cost
$73,332
Indirect Cost
$23,388
Name
University of Wisconsin Madison
Department
Type
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Baker, Timothy B (2017) The 2016 Ferno Award Address: Three Things. Nicotine Tob Res 19:891-900
Nahum-Shani, Inbal; Dziak, John J; Collins, Linda M (2017) Multilevel Factorial Designs With Experiment-Induced Clustering. Psychol Methods :
Piper, Megan E; Cook, Jessica W; Schlam, Tanya R et al. (2017) Toward precision smoking cessation treatment II: Proximal effects of smoking cessation intervention components on putative mechanisms of action. Drug Alcohol Depend 171:50-58
Piper, Megan E; Vasilenko, Sara A; Cook, Jessica W et al. (2017) What a difference a day makes: differences in initial abstinence response during a smoking cessation attempt. Addiction 112:330-339
Piper, Megan E; Schlam, Tanya R; Cook, Jessica W et al. (2017) Toward precision smoking cessation treatment I: Moderator results from a factorial experiment. Drug Alcohol Depend 171:59-65
Chen, Li-Shiun; Baker, Timothy; Brownson, Ross C et al. (2017) Smoking Cessation and Electronic Cigarettes in Community Mental Health Centers: Patient and Provider Perspectives. Community Ment Health J 53:695-702
Jorenby, Douglas E; Smith, Stevens S; Fiore, Michael C et al. (2017) Nicotine levels, withdrawal symptoms, and smoking reduction success in real world use: A comparison of cigarette smokers and dual users of both cigarettes and E-cigarettes. Drug Alcohol Depend 170:93-101
Hartz, Sarah M; Horton, Amy C; Hancock, Dana B et al. (2017) Genetic correlation between smoking behaviors and schizophrenia. Schizophr Res :
King, Cecile C; Piper, Megan E; Gepner, Adam D et al. (2017) Longitudinal Impact of Smoking and Smoking Cessation on Inflammatory Markers of Cardiovascular Disease Risk. Arterioscler Thromb Vasc Biol 37:374-379
Baker, Timothy B; Smith, Stevens S; Bolt, Daniel M et al. (2017) Implementing Clinical Research Using Factorial Designs: A Primer. Behav Ther 48:567-580

Showing the most recent 10 out of 61 publications