Adolescent smokers (aged 14-18;>10 cigarettes/day) attending continuation high schools in the San Francisco-San Jose Bay Area will serve as the target population for this study. 400 smokers meeting eligibility criteria will be randomized. Our primary goal is to examine the effectiveness of a multi-factor extended treatment strategy in promoting longer-term smoking abstinence. AN 400 smokers will receive 10 weeks of open label treatment consisting of nicotine patch therapy and group-based, intensive self- regulatory skills training (ST). Following open label treatment, half (n=200) will receive nine additional group-based ST sessions delivered over a 14 week period. Telephone counseling will also be provided in conjunction with an Interactive Voice Response system (IVR) that will allow early detection of smoking """"""""slips"""""""" and rapid response by treatment staff. The other half (n=200) will not receive any additional therapy beyond that provided in the open label treatment phase. Abstinence and relapse will be assessed at the end of open label (10 weeks) and extended treatment (24 weeks) and at 52 weeks from the time of study entry. Our primary hypothesis is that smokers randomized to extended treatment will have a higher prolonged abstinence rate (PA) at 25 week follow-up than participants receiving only open label treatment. PA at 25 weeks will be the outcome measure used to evaluate the primary hypothesis and will be defined as a report of non-smoking following an initial 2-week grace period during which any smoking is not counted as a failure. Here, failure is defined as either seven consecutive days of smoking or smoking on at least one day on each of two consecutive weeks. Point prevalence abstinence will be examined as a secondary outcome and defined as no smoking, not even a puff, for seven consecutive days prior to assessment and an expired-air carbon monoxide level of <9PPM. The proposed study will address several important gaps in our knowledge of how to help adolescent smokers quit smoking. First, to our knowledge, the study will be the first to examine the effects of a longer- lasting cessation program for adolescent smokers. Second, the study will be one of the first to combine psychological treatment and anti-smoking medication for adolescent smokers. Third, the trial will carefully examine a range of factors that may help or hinder adolescent smokers'ability to quit smoking. The study will provide important practical information to the medical and health communities concerning the usefulness of anti-smoking medication and psychological treatment in helping adolescent smokers to quit.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA118035-05
Application #
7936913
Study Section
Special Emphasis Panel (ZRG1-RPHB-H (90))
Program Officer
Hunt, Yvonne M
Project Start
2006-09-15
Project End
2011-07-31
Budget Start
2010-08-01
Budget End
2011-07-31
Support Year
5
Fiscal Year
2010
Total Cost
$461,978
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Bailey, Steffani R; Hagen, Sarah A; Jeffery, Christina J et al. (2013) A randomized clinical trial of the efficacy of extended smoking cessation treatment for adolescent smokers. Nicotine Tob Res 15:1655-62
Bailey, Steffani R; Crew, Erin E; Riske, Emily C et al. (2012) Efficacy and tolerability of pharmacotherapies to aid smoking cessation in adolescents. Paediatr Drugs 14:91-108
Bailey, Steffani R; Jeffery, Christina J; Hammer, Sarah A et al. (2012) Assessing teen smoking patterns: the weekend phenomenon. Drug Alcohol Depend 120:242-5
Bailey, Steffani R; Harrison, Christopher T; Jeffery, Christina J et al. (2009) Withdrawal symptoms over time among adolescents in a smoking cessation intervention: do symptoms vary by level of nicotine dependence? Addict Behav 34:1017-22