The prevalence of cigarette smoking among individuals in substance use disorder (SUD) treatment remains at about 70% or higher even as the smoking rate in the general population has declined to 20.6%. Smokers in SUD treatment bear an especially large proportion of the tobacco morbidity and mortality burden in the U.S. and ultimately are more likely to die from their tobacco use than from their other substance use. Yet the availability of smoking cessation services in SUD treatment remains relatively uncommon. The long-term goal of this program of research is to disseminate an effective, brief computer-based intervention that can be readily integrated into SUD treatment programs to motivate tobacco quitline use in patients who smoke. The overall objective of this application, which is the first step in the attainment of this long-term goal, is to fully develop this computer-based intervention, modify it based on initial piloting and feedback to insure its feasibility and acceptability, and obtain preliminary data supporting the efficacy of the intervention. This will b accomplished by pursuing three specific aims: 1) to develop and conduct preliminary pilot testing (n=20) of a brief, computer-based intervention intended to motivate tobacco quitline use among cigarette smokers in SUD treatment (TIME-TQ;Tablet computer Intervention to Motivate Engagement in Tobacco Quitline use) and to develop and pilot test a computer-based, time matched control intervention (CON), 2) to conduct a preliminary randomized controlled trial (RCT) with 60 smokers in SUD treatment, comparing TIME-TQ vs. CON, with predictions that TIME-TQ relative to CON will result in increased readiness, higher rates of tobacco treatment engagement, more quit smoking attempts and higher rates of 7-day point prevalence abstinence rates at 1- and 3-month follow-ups. Substance use outcomes over the course of the 3-month follow-up period will also be examined, and 3) to examine TIME-TQ's effects on key mechanisms during the computer session and their associations with tobacco treatment engagement and smoking outcomes at 1- and 3-month follow-ups. The research proposed is innovative in that: 1) no previous studies have implemented a computer-based motivational intervention targeting tobacco use in an SUD treatment setting, 2) the TIME-TQ intervention proposed in this application is focused on promoting tobacco treatment engagement rather than smoking cessation, per se, and 3) no previous studies have attempted to link smokers in SUD treatment with free tobacco quitlines, an efficacious and readily available resource. It is anticipated that the TIME-TQ intervention resulting from this project will have potential for broad reach to SUD treatment programs and if effective in motivating tobacco quitline use among smokers in SUD treatment, will have significant overall impact in reducing smoking-related morbidity and mortality and in advancing scientific knowledge regarding brief, computer-based tobacco interventions to increase quitline utilization.
The proposed research is relevant to public health because smokers in substance use disorder (SUD) treatment suffer from disproportionately high rates of tobacco morbidity and mortality, and yet the availability of smoking cessation services in SUD treatment remains relatively uncommon. The long-term goal of this program of research is to disseminate an effective, brief computer-based intervention that can be readily integrated into SUD treatment programs to motivate tobacco quitline use in patients who smoke. It is anticipated that the computer-based intervention resulting from this project will have potential fo broad reach to SUD treatment programs and if effective in motivating tobacco quitline use among smokers in SUD treatment, will have significant overall impact in reducing smoking-related morbidity and mortality and in advancing scientific knowledge regarding brief, computer-based tobacco interventions to increase quitline utilization.
| Brown, Richard A; Hecht, Jacki; Bloom, Erika L et al. (2017) Development and preliminary pilot evaluation of a brief tablet computer intervention to motivate tobacco quitline use among smokers in substance use treatment. Am J Addict 26:587-594 |
