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 #
5R01CA141663-03
Application #
8113438
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
2011-08-01
Budget End
2012-07-31
Support Year
3
Fiscal Year
2011
Total Cost
$262,809
Indirect Cost
Name
University of Alabama Birmingham
Department
Psychiatry
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Henry, Samantha K; Grant, Merida M; Cropsey, Karen L (2018) Determining the optimal clinical cutoff on the CES-D for depression in a community corrections sample. J Affect Disord 234:270-275
Clark, C Brendan; Swails, Jeffrey A; Akao, Karen A et al. (2018) Gaging the impact of multiple substance use on community corrections involvement. Addict Behav 81:55-59
Montgomery, LaTrice; Schiavon, Samantha; Cropsey, Karen (2018) Factors Associated With Marijuana Use Among Treatment-seeking Adult Cigarette Smokers in the Criminal Justice Population. J Addict Med :
Schiavon, Samantha; Hodgin, Kathleen; Sellers, Aaron et al. (2018) Differences among cigarette-only smokers compared to dual users of cigarettes and little cigars/cigarillos in the criminal justice population. Addict Behav 90:236-240
Savage, Rebekah J; King, Vinetra L; Clark, C Brendan et al. (2017) Factors associated with early marijuana initiation in a criminal justice population. Addict Behav 64:82-88
Cropsey, Karen L; Clark, C Brendan; Stevens, Erin N et al. (2017) Predictors of medication adherence and smoking cessation among smokers under community corrections supervision. Addict Behav 65:111-117
Clark, C Brendan; Zyambo, Cosmas M; Li, Ye et al. (2016) The impact of non-concordant self-report of substance use in clinical trials research. Addict Behav 58:74-9
Cropsey, Karen L; Clark, C Brendan; Zhang, Xiao et al. (2015) Race and Medication Adherence Moderate Cessation Outcomes in Criminal Justice Smokers. Am J Prev Med 49:335-44
Cropsey, Karen L; Jardin, Bianca F; Burkholder, Greer A et al. (2015) An Algorithm Approach to Determining Smoking Cessation Treatment for Persons Living With HIV/AIDS: Results of a Pilot Trial. J Acquir Immune Defic Syndr 69:291-8
Bardeen, Joseph R; Stevens, Erin N; Clark, Charles Brendan et al. (2015) Cognitive risk profiles for anxiety disorders in a high-risk population. Psychiatry Res 229:572-6

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