Improving the Population-Wide Effectiveness of U.S. Tobacco Cessation Quitlines
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation, Smoking Cessation |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | April 2010 |
| End Date: | November 2011 |
Research shows that smoking cessation is the most significant preventable health behavior
change that a person can make to lower cancer risk. In addition, telephone quitlines are an
effective, science-based smoking cessation treatment that is universally accessible to
smokers in the U.S. However, little research has explored promising approaches that could
increase quitline use, improve quit rates, and inform resource allocation for quitline
services. The proposed study will test three promising enhancements to the standard quitline
treatment that typically consists of counseling and, possibly 2 weeks of a NRT medication.
These enhancements are: 1) combination nicotine replacement therapy as recommended by the
United States Public Health Service Clinical Practice Guideline on Treating Tobacco Use and
Dependence; 2) extended duration of cessation medication use; and 3) an innovative
counseling addition - cognitive medication adherence counseling - to optimize adherence to
cessation medication. In addition, the cost-effectiveness of each intervention will be
calculated. The findings of the proposed research have broad potential application and
relevance to state quitlines, quitline service providers, and other purchasers of quitline
services such as employers and insurers. Additionally, the study findings can potentially
inform other telephone health behavior counseling programs.
change that a person can make to lower cancer risk. In addition, telephone quitlines are an
effective, science-based smoking cessation treatment that is universally accessible to
smokers in the U.S. However, little research has explored promising approaches that could
increase quitline use, improve quit rates, and inform resource allocation for quitline
services. The proposed study will test three promising enhancements to the standard quitline
treatment that typically consists of counseling and, possibly 2 weeks of a NRT medication.
These enhancements are: 1) combination nicotine replacement therapy as recommended by the
United States Public Health Service Clinical Practice Guideline on Treating Tobacco Use and
Dependence; 2) extended duration of cessation medication use; and 3) an innovative
counseling addition - cognitive medication adherence counseling - to optimize adherence to
cessation medication. In addition, the cost-effectiveness of each intervention will be
calculated. The findings of the proposed research have broad potential application and
relevance to state quitlines, quitline service providers, and other purchasers of quitline
services such as employers and insurers. Additionally, the study findings can potentially
inform other telephone health behavior counseling programs.
The study design is a fully crossed 2x2x2 factorial design that tested the effect of two
versus six weeks of nicotine replacement therapy (NRT), the effect of NRT monotherapy
(nicotine patch alone) versus NRT combination therapy (nicotine patch + oral NRT), and the
effect of cognitive medication adherence counseling (CMAC) versus no CMAC. A total of 987
smokers seeking cessation assistance from the Wisconsin Tobacco Quit Line (WTQL) were
randomly assigned to the eight (2x2x2) different conditions generated by the three
experimental factors. This design provides us with sufficient power to analyze each of our
three main effects listed above. We will also test for two- and three-way interactions, but
do not have sufficient data to make a priori assumptions about interaction effects. Finally,
we will conduct a cost-effectiveness analysis for each of the three interventions to allow
readers of this research to evaluate whether the additional costs of the interventions yield
sufficient gains to warrant implementing them broadly.
versus six weeks of nicotine replacement therapy (NRT), the effect of NRT monotherapy
(nicotine patch alone) versus NRT combination therapy (nicotine patch + oral NRT), and the
effect of cognitive medication adherence counseling (CMAC) versus no CMAC. A total of 987
smokers seeking cessation assistance from the Wisconsin Tobacco Quit Line (WTQL) were
randomly assigned to the eight (2x2x2) different conditions generated by the three
experimental factors. This design provides us with sufficient power to analyze each of our
three main effects listed above. We will also test for two- and three-way interactions, but
do not have sufficient data to make a priori assumptions about interaction effects. Finally,
we will conduct a cost-effectiveness analysis for each of the three interventions to allow
readers of this research to evaluate whether the additional costs of the interventions yield
sufficient gains to warrant implementing them broadly.
The only people eligible for this study are Wisconsin residents who contact the Wisconsin
Tobacco Quit Line for smoking cessation services.
Inclusion Criteria:
- Callers will be eligible to participate in the study if they are English speaking;
are 18 years of age or older; smoke a minimum of 10 cigarettes per day; are
interested in quitting and are willing to set a quit date; willing and able to use
nicotine patch and nicotine gum; agree to receive four follow-up counseling calls
from Free & Clear (the quitline vendor for the State of Wisconsin); provide verbal
informed consent; and provide contact information and agree to take four study
follow-up calls from staff at the University of Wisconsin Center for Tobacco Research
and Intervention.
Exclusion Criteria:
- Callers will be excluded if they are under the age of 18; are pregnant or
breastfeeding; exclusively use other forms of tobacco (e.g., smokeless tobacco); are
unwilling or unable to use study NRT medications; are currently using a cessation
medication (NRT, bupropion, varenicline); or have medical exclusions as per
FDA-approved product labeling.
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