Abstinence Reinforcement Therapy (ART) for Homeless Veteran Smokers
Condition: Tobacco Use Disorder; Homelessness
MeSH terms: Tobacco Use Disorder
Intervention: Nicotine Patches; mobile contingency management (mCM); Smoking cessation counseling; Nicotine rescue method; Bupropion
Intervention description: Nicotine replacement therapy in the form of nicotine patches will be provided to ART group participants beginning on their smoking quit date. Nicotine patches may be provided to control group participants as part of usual care.; Mobile contingency management (mCM) is a behavioral intervention designed to provide positive reinforcement for remaining abstinent from smoking. In this intervention, participants are loaned a smart phone equipped with a videocamera and a carbon monoxide (CO) monitor. Participants are trained to upload videos of themselves taking CO readings. Any time a participant uploads a video recording that suggests abstinence (i.e., low CO reading), he/she will be provided a monetary reward.; Smoking cessation counseling is a cognitive-behavioral treatment designed to prepare participants for a quit attempt, and to address relapse when necessary.; Nicotine replacement therapy in the form of nicotine gum or lozenges will be provided to ART group participants beginning on their smoking quit date. Nicotine gum or lozenges may be provided to control group participants as part of usual care.; Bupropion SR may be prescribed to medically eligible ART group participants beginning one week prior to quit date. Bupropion may also be prescribed to control group participants as part of usual care.
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: 133.0
Sex: All
Minimum age: 18 Years
Maximum age: 70 Years
Healthy volunteers: No
Keywords: Tobacco use cessation; Homelessness; Veterans

Summary:

      The goal of this research study is to examine the effects of a treatment for helping homeless
      veterans who smoke to stop smoking. Participants in the study will be assigned to one of two
      study groups. Participants in the first group will be referred to the local Department of
      Veterans Affairs Medical Center's Smoking Cessation Clinic for treatment. Second group
      participants will receive a behavioral treatment designed to reward smokers for quitting and
      staying quit. These participants will also receive telephone counseling and medications for
      smoking cessation.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Veteran

          -  Homeless

          -  Enrolled in Durham VA Medical Center for medical care

          -  Current smoker (at least 10 cigarettes per day)

          -  Willing to quit smoking in the next 30 days

        Exclusion Criteria:

          -  Active substance dependence other than nicotine

          -  Uncontrolled psychotic symptoms

          -  Severely impaired hearing or speech (must be able to respond to telephone calls)

          -  Lack of interest in receiving telephone care

          -  Pregnancy