family-supported smoking cessation for chronically ill veterans

Conditions: Chronic Disease; Neoplasm; Cardiovascular Disease; Pulmonary Disease, Chronic Obstructive; Diabetes Mellitus; Hypertension

Summary: the overarching aim of the study is to evaluate in a randomized trial the impact of a family-supported intervention compared to a standard veteran-focused telephone counseling control group to promote smoking cessation among cancer and heart disease patients.

anticipated impact(s) on veteran's healthcare: veterans with chronic disease who continue to smoke exact a significant burden on the va health care system. effective smoking cessation programs, that target veterans who continue to smoke after the diagnosis of a smoking-related chronic illness, are needed. background/rationale: chronic diseases related to tobacco exposure are common among veterans. persistent tobacco use after being diagnosed with these diseases decreases quality of life and survival. yet, 30% of veterans with these conditions continue to smoke. researchers have found that the social environment is important for smokers. in our current nci-funded study, 70% of veterans with lung cancer identified at least one family member who smokes and 45% live with a family member that smokes. a family-supported smoking cessation intervention timed to follow a veteran's diagnosis of cancer or heart disease could be effective for helping veterans quit smoking. objectives: the overarching aim of the study is to evaluate in a randomized trial the impact of a family-supported intervention compared to a standard veteran-focused telephone counseling control group to promote smoking cessation among cancer and heart disease patients. aim 1: to evaluate the impact of a family-supported intervention on rates of abstinence from cigarettes (self-reported 7-day point prevalent abstinence) at 2 weeks, and 12-month post-treatment follow-ups. hypothesis 1: abstinence rates will be significantly higher among veterans who receive the family-supported intervention than those who receive the standard telephone counseling control. aim 2: to evaluate the impact of a family-supported intervention on perceived support for quitting 2 weeks and 12-month post-treatment follow-ups. hypothesis 2: perceived support for quitting smoking will be significantly greater among veterans who receive the family-supported intervention than those who receive the standard telephone counseling control. aim 3: to measure the impact of a family-supported intervention on quality of life in veterans 2 weeks, and 12-month post-treatment follow-ups. hypothesis 3: symptom-related quality of life will be significantly greater among veterans who receive the family-supported intervention than those who receive the standard telephone counseling control. methods: proposed is a two-group design in which 470 veterans who smoke will be randomized to receive: standard telephone counseling control including a letter from a va physician encouraging the patient to quit smoking, nicotine replacement (if not contraindicated), a self-help cessation kit, and 5 standard telephone counseling calls; or family-supported intervention that includes all components of the control arm plus a family-supported intervention that includes a support skills booklet and an additional telephone counseling protocol focusing on social support. .

Eligibility criteria:
inclusion criteria: * enrolled in the durham va for ongoing care * seen at a dvamc clinic for care of cancer or cardiovascular disease within the previous 3 months * current smokers and planning to quit smoking in the next 30 days exclusion criteria: * active diagnosis of psychosis documented in medical record * does not have access to a telephone * refusal to provide informed consent * severely impaired hearing or speech

Keywords: veterans smoking cessation