Striving to Quit-Wisconsin Tobacco Quit Line

Study Overview
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Brief Summary
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This study is designed to test the hypotheses that incentives can increase both participation in smoking cessation treatment and resulting cessation rates when they are offered to Medicaid BadgerCare Plus members.

Detailed Description
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Aim 1: To determine the extent to which contingent financial treatment incentives (i.e., incentives for biochemical verification visits, treatment engagement, and abstinence) versus attendance incentives (i.e., incentives for only attending the biochemical verification visits), increase rates of smoking cessation . Participants will be BadgerCare Plus tobacco users who enroll in Wisconsin Tobacco Quit Line (WTQL) services. Aim 2: To determine the extent to which treatment incentives vs. attendance incentives increase rates of engagement in smoking cessation treatment through the WTQL when offered to BadgerCare Plus members who smoke. Aim 3: To determine the cost-effectiveness of the smoking cessation program when paired with treatment incentives and when paired with attendance incentives. Aim 4: To identify moderating and mediational effects regarding the clinical benefit of incentivized smoking treatment Aim 5: To determine the reach of an incentivized smoking cessation treatment that depends upon primary care clinic staff, a fax-to-quit referral mechanism and a state quit line.

Official Title
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Striving to Quit: Wisconsin Tobacco Quit Line Tobacco Cessation Research

Conditions
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Smoking Cessation, Smoking, Nicotine Dependence

Intervention / Treatment
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* Behavioral: Incentives for abstinence and treatment engagement
* Behavioral: Attendance incentive


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: enrollment in Wisconsin Medicaid (BadgerCare Plus) resides in study area (one of 25 counties) member of participating HMOs 18 or older English speaking has smoked daily (at least 5 cigarettes each day) over the last week willingness to attend visits at his/her PCC (primary care clinic) every 6 months (3 times over a 12 month period), provide urine samples, and complete follow-up phone calls willingness to inform the WTQL as to any change in address, phone number, clinic attended, or health plan. Exclusion Criteria: not enrolled in Wisconsin Medicaid (BadgerCare Plus) not reside in study area not a member participating HMOs less than 18 years of age not English speaking does not smoke daily (at least 5 cigarettes each day) over the last week not willing to attend visits at his/her PCC (primary care clinic) every 6 months (3 times over a 12 month period), provide urine samples, and complete follow-up phone calls. not willing to inform the WTQL as to any change in address, phone number, clinic attended, or health plan.

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment incentives<br>Incentives for biochemical verification visits, treatment engagement, and abstinence | Behavioral: Incentives for abstinence and treatment engagement<br>* Treatment incentives - incentives for biochemical verification visits, treatment engagement and abstinence<br>|
| Active Comparator: Attendance incentive<br>Incentives for only attending the biochemical verification visits | Behavioral: Attendance incentive<br>* Attendance Incentives - incentives for only attending the biochemical verification visits<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Abstinence from smoking | The data will be the biochemically confirmed reports of abstinence for the past 7 days (i.e., 7-day point-prevalence abstinence) | Measured 6 months after enrollment at follow-up assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Engagement in treatment | The primary analyses will compare number of calls completed | Measured 12 months after enrollment at follow-up assessment | 
| Cost-effectiveness | The primary analysis will contrast the incremental costs of the treatment vs. attendance conditions by computing the Incremental Cost-Effectiveness Ratio (ICER) with regard to attaining 6-month abstinence. | Measured 12 months after enrollment |