Smoking prevalence among individuals in the criminal justice system is approximately 3- 4 times higher than among individuals outside the criminal justice system and few smoking cessation interventions have targeted this population. One large RCT of female prisoners tested nicotine replacement and 10-session group intervention compared to a wait-list control group and found comparable cessation rates with other community trials. However, smoking cessation interventions have not been conducted with individuals outside penal institutions under community corrections supervision, despite the need to test smoking interventions with low income and other underserved populations. The proposed site, community corrections, has a racially diverse (60% African-American), low income population who do not have access to smoking cessation interventions. This study proposes to examine using bupropion as the platform to examine two different behavioral interventions for smoking cessation with this low income, adult population stratifying for race: a 4 session, intensive counseling intervention compared to an initial session of physician counseling to quit (standard of care). All participants will be treated for 12 weeks with bupropion and abstinence rates will be determine based on cotinine and expired CO for baseline, 4 weekly counseling sessions, weeks 8 and 12 (end-of- treatment). Follow-ups will be at 6, 9 and 12 months after study enrollment. GEE analyses will be used to examine the effect of the intervention over multiple time points and it is believed that African-American smokers will continue to have lower smoking cessation rates compared to Caucasian smokers, although this effect is expected to be attenuated using the motivational interviewing intervention. This study fulfills the RFA mission by examining a novel treatment delivery setting (community corrections) with a low income population who do not have access to smoking cessation treatment using buproprion and comparing two intensities of behavioral therapy. If efficacy is demonstrated, this study would provide a model for integrating smoking cessation treatment in existing programs for community corrections offenders to help provide treatment to a low income and underserved population.

Public Health Relevance

Smoking is now concentrated in low income and other disadvantaged populations such as community corrections. Providing smoking cessation services integrated with community corrections has the potential to provide these services to a low income population who are not able to access community smoking cessation interventions due to lack of insurance and other poverty issues. This project has the potential to reduce the morbidity and mortality associated with smoking with this low income, community corrections population.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA141663-05
Application #
8509620
Study Section
Special Emphasis Panel (ZCA1-SRRB-Y (M1))
Program Officer
Augustson, Erik
Project Start
2009-08-14
Project End
2014-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
5
Fiscal Year
2013
Total Cost
$247,041
Indirect Cost
$53,283
Name
University of Alabama Birmingham
Department
Psychiatry
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Cropsey, Karen L; Leventhal, Adam M; Stevens, Erin N et al. (2014) Expectancies for the effectiveness of different tobacco interventions account for racial and gender differences in motivation to quit and abstinence self-efficacy. Nicotine Tob Res 16:1174-82
Jardin, Bianca F; Cropsey, Karen L; Wahlquist, Amy E et al. (2014) Evaluating the effect of access to free medication to quit smoking: a clinical trial testing the role of motivation. Nicotine Tob Res 16:992-9
Cropsey, Karen L; Trent, Lindsay R; Clark, Charles B et al. (2014) How low should you go? Determining the optimal cutoff for exhaled carbon monoxide to confirm smoking abstinence when using cotinine as reference. Nicotine Tob Res 16:1348-55
Cropsey, Karen L; Hendricks, Peter S; Jardin, Bianca et al. (2013) A pilot study of screening, brief intervention, and referral for treatment (SBIRT) in non-treatment seeking smokers with HIV. Addict Behav 38:2541-6
Clark, C Brendan; Waesche, Matthew C; Hendricks, Peter S et al. (2013) The relationship between prior suicidal behavior and mortality among individuals in community corrections. Crisis 34:428-33
Binswanger, Ingrid A; Mueller, Shane; Clark, C Brendan et al. (2011) Risk factors for cervical cancer in criminal justice settings. J Womens Health (Larchmt) 20:1839-45