Mobile Contingency Management for Concurrent Abstinence From Alcohol and Smoking
Condition: Smoking Cessation; Alcohol Drinking
MeSH terms: Alcohol Drinking
Study type: Interventional
Phase: Phase 4

Summary: 
      Alcohol misuse and smoking constitute two of the three leading preventable causes of death in
      the United States. The purpose of this research study is to develop an intervention designed
      to help people stop drinking alcohol and stop smoking at the same time.
    

Detailed description: 
      Alcohol misuse and smoking constitute two of the three leading preventable causes of death in
      the United States. Reluctance to treat tobacco dependence among those with AUD is misguided
      as recent research suggests smoking cessation treatment can be effective, does not increase
      risk of relapse to alcohol, and may even improve rates of sobriety. There is strong evidence
      for the short-term efficacy for alcohol misuse 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. 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. This mobile CM (mCM) approach paired with
      cognitive-behavioral counseling and pharmacological smoking cessation aids has been effective
      in reducing smoking.

      Thus, the purpose of this project is to develop a combined alcohol and smoking mCM
      intervention. The intervention will be developed in two successive cohorts of five
      participants, who will provide information on treatment acceptability and feasibility. A
      third cohort of participants (n=45) will participate in a randomized clinical trials to
      further examine feasibility and efficacy. The long term goal is to develop mCM procedures
      that will be used as part of a multi-component intervention to concurrently and effectively
      treat both alcohol misuse and smoking. As part of this project, the investigators will
      develop a multi-component telehealth alcohol and smoking mCM intervention. It will include
      mCM, cognitive-behavioral phone counseling, and standard smoking cessation pharmacotherapy.
      The work proposed in these 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 alcohol misuse and smoking.
    

Intervention name(s): Nicotine Replacement Therapy; Bupropion; Cognitive Behavioral Treatment; Mobile Contingency Management; Mobile Monitoring
Intervention type(s): Other; Drug; Behavioral; Behavioral; Behavioral
Intervention description(s): Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or nicotine lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings; All participants who are medically eligible will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up.; Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation.; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Other intervention name(s): nicotine gum, patch, inhaler, and/or lozenge; Zyban; CBT; mobile CM, mCM
Intervention MeSH terms: Bupropion; Nicotine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment