Mobile Health Technology to Enhance Abstinence in Smokers With Schizophrenia
Condition: Schizophrenia; Cigarette Smoking
MeSH terms: Schizophrenia
Study type: Interventional
Phase: Phase 4

Summary: 
      This study is designed to evaluate if a treatment the investigators call iCOMMIT is effective
      at helping smokers with schizophrenia stop smoking. iCOMMIT is a smoking cessation treatment
      that combines mobile technology with behavioral strategies, counseling, and medications.
    

Detailed description: 
      The purpose of this 2-arm randomized controlled trial (RCT) is to evaluate the efficacy of
      Multi-Component Mobile-enhanced Treatment for Smoking Cessation (iCOMMIT) in helping
      individuals with schizophrenia or other psychotic disorders stop smoking. Eligible
      participants will be randomized to receive iCOMMIT, which includes smoking cessation
      counseling, pharmacotherapy, and mobile technology components, or a control intervention that
      includes smoking cessation counseling and pharmacotherapy, but no mobile technology
      components. The control condition represents an intensive standard of care and helps control
      for monitoring, counselor, time, and attention effects.

      The primary outcome for the study will be self-reported and bio-verified prolonged smoking
      abstinence at the 6-month follow-up. Self-reported prolonged abstinence will be verified by
      saliva cotinine assay. Secondary outcomes will include 7- and 30-day point prevalence
      abstinence at each assessment, where abstinence is defined as no tobacco use in the prior 7
      or 30 days.
    

Intervention name(s): Nicotine replacement therapy; Bupropion; cognitive-behavioral smoking cessation counseling; Mobile Contingency Management; Stay Quit Coach; SMS text messaging
Intervention type(s): Drug; Drug; Behavioral; 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, nicotine inhaler, or nicotine nasal spray, 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 3-month follow-up; Participants will receive four 20-minute smoking cessation counseling sessions and a participant manual. The four sessions are based on standard cognitive-behavioral therapy techniques shown to be efficacious for smoking cessation.; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for videos that suggest smoking abstinence.; Stay Quit Coach is a smart phone application that serves as a source of readily available support and information for adults who are already in treatment to quit smoking and to help them stay quit after treatment. The app guides user in creating tailored plans that include their personal reasons for quitting, interactive tools to help users cope with urges to smoke, motivational messages, support contacts to help users stay smoke free and how to address lapses. Participants assigned to this condition will be asked to use Stay Quit Coach from Session 2 through the 6-month follow-up.; Patients assigned to this condition will receive text messages relevant to their current status in their smoking quit attempt, including messages reminding participants to take their smoking cessation medication.
Other intervention name(s): nicotine gum, patch, inhaler, and/or lozenge; Zyban; mCM; texting
Intervention MeSH terms: Bupropion; Nicotine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment