Mobile Contingency Management for Marijuana and Tobacco Cessation
Condition: Cigarette Smoking; Marijuana Abuse
MeSH terms: Marijuana Abuse
Study type: Interventional

Summary: 
      The purpose of this pilot project is to pilot-test a combined cannabis and smoking cessation
      treatment. The intervention combines mobile technology with behavioral strategies,
      counseling, and medications.
    

Detailed description: 
      Cannabis is the most widely used illicit drug in the United States with 19.8 million current
      users. Population based data indicate that almost all cannabis users (90%) have a lifetime
      history of tobacco smoking and the majority (74%) currently smoke tobacco. While cannabis use
      alone is associated with significant adverse health effects, tobacco smoking is the number
      one preventable cause of illness and death in the U.S. This is true even among those using
      illicit drugs where the tobacco -related mortality rate is twice that of the general
      population. Among cannabis users, smoking tobacco is associated with increased frequency of
      marijuana use, increased morbidity, and poorer cannabis cessation outcomes. There is strong
      evidence for the short -term efficacy for cannabis use disorder (CUD) and smoking of
      contingency management (CM). It is an intensive behavioral therapy that provides incentives
      (vouchers, money) to individuals misusing substances contingent upon objective evidence from
      drug use. Implementation of CM has been limited because of the need to verify abstinence
      multiple times daily using clinic based monitoring and effects are short lived. The
      investigators recently developed a smart -phone application which allows a patient to video
      themselves several times daily while using a small CO monitor and to transmit the data to a
      secure server which has made the use of CM for outpatient smoking cessation portable and
      feasible. The mobile CM (mCM) approach paired with cognitive-behavioral counseling and
      pharmacological smoking cessation aids has been effective in reducing smoking in the short
      and long-term. The purpose of this pilot project is to pilot-test a combined cannabis and
      smoking mCM intervention. The pilot will allow the investigators to examine feasibility of
      the treatment and of planned recruitment strategies. These project aims will provide the
      first step toward implementation of an innovative approach that builds upon the power of
      mHealth technology to reduce the prevalence of both CUD and cigarette smoking.
    

Intervention name(s): bupropion; transdermal nicotine patch; Nicotine polacrilex; nicotine lozenge; counseling for marijuana and smoking cessation; mobile contingency management
Intervention type(s): Drug; Drug; Drug; Drug; Behavioral; Behavioral
Intervention description(s): Prescribed one week prior to quit and continued until the 6 month follow-up visit.; Initiated at smoking quit date; 7 mg to 21 mg patch depending on amount smoked by participant; Initiated at smoking quit date.; Initiated at smoking quit date.; 5 sessions of cognitive-behavioral counseling designed to facilitate marijuana and smoking cessation and promote relapse prevention; treatment that provides money rewards for abstinence from smoking and marijuana
Other intervention name(s): Zyban; nicotine gum; nicorette
Intervention MeSH terms: Bupropion; Nicotine
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment