Mobile Health Technology to Enhance Abstinence in Smokers With Schizophrenia
Condition: Schizophrenia; Cigarette Smoking
MeSH terms: Schizophrenia
Intervention: Nicotine replacement therapy; Bupropion; cognitive-behavioral smoking cessation counseling; Mobile Contingency Management; Stay Quit Coach; SMS text messaging
Intervention description: 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.
Intervention MeSH terms: Bupropion; Nicotine
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 35.0
Sex: All
Minimum age: 18 Years
Maximum age: 70 Years
Healthy volunteers: No

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.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Currently smoke at least ten cigarettes a day

          -  Have been smoking for at least one year

          -  Meet criteria for schizophrenia, schizoaffective disorder, or another psychotic
             disorder based on structured clinical interview

          -  Can speak and write fluent conversational English

          -  Are between 18 and 70 years of age

          -  Are willing to make a smoking cessation attempt

          -  Score 26 or higher on the Montreal Cognitive Assessment

        Exclusion Criteria:

          -  Have a history of myocardial infarction in the past 6 months

          -  Have a contraindication to NRT with no medical clearance from the primary care
             provider or study physician

          -  Use and unwillingness to stop use of other forms of nicotine such as cigars, pipes, or
             chewing tobacco

          -  Are pregnant

          -  Meet criteria for a current manic episode based on structured clinical interview

          -  Are currently enrolled in another smoking cessation trial

          -  Are currently imprisoned or in psychiatric hospitalization