A Comparative Effectiveness RCT of Optimized Cessation Treatments

The ultimate goal of this research is to develop a chronic care treatment package for smokers
that will address the challenges and opportunities of each phase of the cessation process -
motivation, preparation, cessation, maintenance, and relapse recovery. That is, to develop
treatments for smokers not yet ready to quit, those who are preparing to quit, those actively
engaged in the quitting process and those who have tried to quit but relapsed. To achieve
this goal, this research comprises three distinct research studies, each of which represent a
phase in a comprehensive chronic care treatment model for clinical intervention with smokers
in the primary care setting: the Motivation Study, the Cessation Study, and the Long-term
Quitting Study. The goal of each study is to test and identify effective intervention
components for distinct phases of the smoking cessation process. These components will then
be combined for future research on the effectiveness of this chronic care treatment package

Inclusion Criteria:

- age >=18 years

- smoking >4 cigarettes/day for the previous 6 months

- able to read, write, and speak English

- have reliable phone access and agree to respond to Interactive Voice Response (IVR)
phone prompts

- and if currently using NRT, agreeing to use only study medication for the duration of
the study

- we will not exclude participants based on their prior use of cessation medication or
if they use multiple tobacco products in order to enhance real-world generalization
(these will be statistically controlled in analyses)

- not currently attempting to quit smoking

- not intending to quit smoking (defined as no plans to quit in the next month)

- and planning to remain in the intervention catchment area for at least 12 months.

Exclusion Criteria:

- currently taking bupropion or varenicline

- medical contraindications to using NRT including hospitalized (for at least one night)
for a stroke, heart attack, congestive heart failure or diabetes in the last 30 days

- diagnosis of or treatment for schizophrenia, a psychotic disorder or bipolar disorder
in the last 10 years

- and, if the participant is a woman of childbearing potential, being pregnant or
intending to becoming pregnant or unwillingness to use an approved method of birth
control during treatment.