Pain and Smoking Study

Veterans with chronic pain represent an important population in which to focus smoking
cessation efforts. Smoking cessation among patients with chronic medical illnesses
substantially decreases morbidity and mortality; yet, many patients (>50%) with chronic pain
continue to smoke.

This study aims to test the telephone delivery of a cognitive behavioral intervention (CBI),
for smoking cessation among Veteran smokers with chronic pain. Proposed is a randomized
comparative effectiveness trial with a two-group design in which 370 Veteran smokers with
chronic pain will be randomized to either: 1) smoking cessation plus CBI (SMK-CBI), an
intervention that includes a proactive tele-health intervention combining evidence-based
smoking cessation counseling augmented with behavioral approaches for coping with pain and a
tele-medicine clinic for accessing nicotine replacement therapy (NRT), or 2) smoking
cessation telephone counseling control (SMK Control), a contact-equivalent control that
provides standard smoking cessation telephone counseling and a tele-medicine clinic for
accessing NRT.

Inclusion Criteria:

- Veterans enrolled at VA Connecticut or VA Central Western Massachusetts

- Current Cigarette Smokers

- Willing to make quit attempt in next 30 days

- Pain intensity 4 or greater on scale 0-10, self-reported

Exclusion Criteria:

- Non-English speaking

- No access to telephone/Lack of Telephone Access

- Severely impaired hearing

- Active diagnosis

- Terminal Illness

- Refusal to provide informed consent

- Enrolled in concurrent smoking cessation programs/research