Tailored Tobacco Quitline for Rural Veterans
Condition: Cigarette Smoking
Intervention: Nicotine replacement therapy - transdermal nicotine patch; Tailored behavioral intervention; Tobacco quit line referral; Nicotine replacement therapy - nicotine gum; Nicotine replacement therapy - nicotine lozenge; Bupropion Sustained Release; Varenicline; Combination pharmacotherapy - transdermal nicotine patch + nicotine gum; Combination pharmacotherapy - transdermal nicotine patch + nicotine lozenge; Combination pharmacotherapy - transdermal nicotine patch + bupropion; Alcohol use risk reduction; Behavioral activation for the treatment of depression; Behavioral management of post-cessation weight gain
Intervention description: Medication selection will be determined based on individual participant preferences, medical history, and contraindications.; Participants will receive a standard six session cognitive behavioral intervention for smoking cessation combined with supplemental treatment modules based on individual need and preference.; Participants assigned to this condition will receive a referral to their state tobacco quit line. The specific behavioral treatment that is provided will differ slightly depending upon the services available through the participant's state of residence.; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Medication selection will be determined based on individual participant preferences, medical history, and contraindications; Participants engaging in risky alcohol use may receive this six-session telephone-based behavioral intervention for reducing alcohol use.; Participants with elevated depressive symptoms may receive this six-session telephone-based behavioral activation intervention.; Participants with concerns about gaining weight after quitting smoking may receive this six-session telephone-based behavioral self-management intervention designed to help attenuate post-cessation weight gain.
Intervention MeSH terms: Ethanol; Bupropion; Nicotine; Varenicline
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Enrollment: 63.0
Sex: All
Minimum age: 18 Years
Maximum age: 99 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Nicotine dependence; Smoking cessation; Telehealth; Alcohol use; Depression; Body weight

Summary:

      The proposed work is designed to help increase access to tobacco cessation services among
      rural veterans and to develop more effective treatment services that better address comorbid
      issues commonly experienced by rural smokers. The objectives are:

        1. Study the feasibility of an individually-tailored telephone intervention for rural
           smokers.

        2. Examine the impact of the intervention on tobacco use outcomes.

        3. Evaluate the effect of the intervention on issues commonly experienced by rural smokers
           including depressive symptoms, alcohol use, and weight gain.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Being a veteran

          -  18 + years of age

          -  Smoke cigarettes on at least a daily basis

          -  Receive primary care from the Iowa City VAMC or Coralville Clinic

          -  Live in a non-metropolitan area (based on RUCA codes)

          -  Be willing to make a quit attempt in the next 30 days

          -  Be capable of providing informed consent

          -  Have access to a telephone (land line or cell phone)

          -  Have a stable residence

        Exclusion Criteria:

          -  Planning to move within the next 12 months

          -  Presence of a terminal illness

          -  Pregnancy

          -  Unstable psychiatric disorder (e.g., acute psychosis)

          -  Currently pregnant

          -  Incarcerated

          -  Institutionalized