Incentives for Smoking Cessation in Persistent Poverty Counties

Study Overview
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Brief Summary
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The proposed pilot project is designed to evaluate the feasibility and potential efficacy of offering small financial incentives for the completion of smoking cessation counseling and self-reported abstinence at follow-up among Oklahoma Tobacco Helpline (OTH) callers living in persistent poverty counties (PPCs). The study will enroll 160 adults who reside in any of the 16 persistent poverty counties in Oklahoma, who are seeking smoking cessation treatment through the OTH.

Detailed Description
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The proposed randomized controlled trial will enroll 160 adults who are seeking smoking cessation treatment through the OTH and who reside in any of the 16 PPCs in Oklahoma. Participants will be randomly assigned to OTH or OTH plus escalating incentives (OTH+I) for completing up to 5 counseling calls over 8 weeks. Feasibility outcomes for the incentives-based intervention will focus on counseling call completion, follow-up assessment completion, smoking cessation, incentive costs, and perceptions of the intervention. Potential effectiveness will be evaluated based on comparisons of counseling call completions and rates of self-reported smoking abstinence at 12 weeks post-enrollment (4 weeks after incentives have ended) in OTH+I relative to OTH alone.

Official Title
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Monetary Incentives to Promote Engagement With the Oklahoma Tobacco Helpline in Counties Experiencing Persistent Poverty

Conditions
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Tobacco Cessation, Tobacco Use, Tobacco Smoking, Smoking Cessation Financial Incentives, Socioeconomic Status, Contingency Management

Intervention / Treatment
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* Behavioral: Standard Care + Financial Incentives
* Other: Standard Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Contact the OTH seeking smoking cessation treatment Reside in any of the 16 PPCs in Oklahoma (Adair, Caddo, Cherokee, Choctaw, Greer, Harmon, Haskell, Hughes, Johnston, McCurtain, Okfuskee, Payne, Pushmataha, Seminole, Sequoyah, Tillman) Report smoking ≥ 5 cigarettes per day Are ≥ 18 years of age Are able to provide a copy/photo of their ID/driver's license or other documentation of identity and residence Be able to read, speak, and understand English Have no contradictions for NRT

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard Care<br>Participants randomized to Standard Care will be offered weekly counseling calls and pharmacotherapy. | Other: Standard Care<br>* Financial Incentives participants will receive standard care for completing counseling calls.<br>|
| Experimental: Standard Care + Financial Incentives<br>Financial Incentives participants will receive standard care for completing counseling calls. | Behavioral: Standard Care + Financial Incentives<br>* Participants randomized to Standard Care will be offered weekly counseling calls and pharmacotherapy.<br>Other: Standard Care<br>* Financial Incentives participants will receive standard care for completing counseling calls.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary Outcome Measure: | The primary outcome measure is self-reported smoking abstinence 7-day point prevalence at 12 weeks post-quit. | 12 weeks post-quit-date | 
| Cost-effectiveness | The incremental cost effectiveness ratio (ICER) calculated as the difference in mean costs between the new (CM) and standard treatment (SC) divided by the difference in mean effectiveness between the two, estimates additional resources needed to achieve an increase of one unit of effectiveness. The ICER is then compared with published threshold values for cost-effective interventions. The cost model will include all necessary personnel, hardware, and material costs. | 12 weeks post-quit-date | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported smoking abstinence | Self-reported 7-day point prevalence abstinence at 8 weeks post-quit-date. | 8 weeks post-quit-date |