Nonadherent use of smoking cessation medications is very common and highly associated with failure to quit smoking. However, little is presently known about how to affect adherence, or whether greater adherence will actually improve cessation success (i.e., its causal role is unknown). Project 3 is designed to address three chief aims: (1) to identify the factors that influence adherence to smoking cessation medication;(2) to determine the association between medication adherence and smoking cessation, and (3) to develop new, cost-effective adherence interventions that are feasible for use in real-world healthcare settings and that improve both medication adherence and smoking cessation outcomes. These research goals will be addressed via two experiments conducted in real-world primary care settings that will assess several types of promising adherence interventions designed to boost both adherence rates and cessation success. These interventions include a cognitive intervention designed to modify smokers'incorrect beliefs about medication and cessation, interventions that provide feedback and problem solving counseling based upon real-time recording of medication use, and a contingency management intervention that reinforces adherence behavior. Strengths of this research are that it will: use smokers recruited in primary care settings;reveal the relative, additive, and interactive effects of these adherence interventions;use multiple, convergent measures to achieve an accurate assessment of adherence;and use mediational analyses to reveal the extent to which adherence change translates into higher abstinence rates. Finally, this research will identify an optimal set of adherence interventions for use in real-world settings. Such interventions might be used for a broad range of health conditions where medication adherence is a problem.

Public Health Relevance

The majority of smokers do not use cessation medications properly during a quit attempt and this decreases the chances of successful quitting. The proposed research will test interventions designed to increase smokers'proper use of cessation medication and will test whether or not this improves cessation success. This research has the potential to improve cessation treatment, and as a result, the health of smokers.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center (P50)
Project #
Application #
Study Section
Special Emphasis Panel (ZDA1-RXL-E)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Wisconsin Madison
United States
Zip Code
Berg, Kristin M; Smith, Stevens S; Piper, Megan E et al. (2018) Identifying Differences in Rates of Invitation to Participate in Tobacco Treatment in Primary Care. WMJ 117:111-115
Schlam, Tanya R; Cook, Jessica W; Baker, Timothy B et al. (2018) Can we increase smokers' adherence to nicotine replacement therapy and does this help them quit? Psychopharmacology (Berl) 235:2065-2075
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
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
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
Petersen, Angela; Mermelstein, Robin; Berg, Kristin M et al. (2017) Offering smoking treatment to primary care patients in two Wisconsin healthcare systems: Who chooses smoking reduction versus cessation? Prev Med 105:332-336
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
Yoo, Woohyun; Yang, JungHwan; Cho, Eunji (2016) How social media influence college students' smoking attitudes and intentions. Comput Human Behav 64:173-182
Piper, Megan E; Fiore, Michael C; Smith, Stevens S et al. (2016) Identifying effective intervention components for smoking cessation: a factorial screening experiment. Addiction 111:129-41
Baker, Timothy B; Collins, Linda M; Mermelstein, Robin et al. (2016) Enhancing the effectiveness of smoking treatment research: conceptual bases and progress. Addiction 111:107-16

Showing the most recent 10 out of 44 publications