Contingency Management for Smoking Cessation in the Homeless

Study Overview
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Brief Summary
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Smoking cessation services are an unmet need among the homeless, who smoke at rates more than 3 times the national estimate; successful interventions in this underserved population have the potential for improving individual and public health. Contingency management (CM) is a behavioral intervention with efficacy in a number of substance use disorder populations, including smokers. However, no known studies have evaluated the effect of CM in homeless smokers. The investigators plan to examine smoking-related outcomes in homeless treatment-seeking smokers (N = 70) randomized to standard care smoking cessation (transdermal nicotine replacement therapy [NRT] + standard counseling + carbon monoxide [CO] monitoring) or standard care plus CM (NRT + standard counseling + CO monitoring + CM) conditions. Standard counseling and CO monitoring will occur for the first 4 weeks, with NRT use continuing through week 8. Participants in both conditions will meet with study staff up to twice daily on weekdays for biochemical verification of smoking status. Participants in the CM condition will have the opportunity to earn prizes for negative breath samples (CO ≤ 4 ppm) up to twice daily on weekdays. CO breath samples will be collected at all visits. The investigators expect that participants randomized to CM will have better outcomes compared to those in standard care.

Official Title
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Contingency Management for Smoking Cessation in the Homeless

Conditions
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Cigarette Smoking

Intervention / Treatment
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* Behavioral: Contingency Management
* Other: Standard of Care
* Other: Standard of Care
* Other: Standard of Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age ≥ 18 years homeless regular smoker Exclusion Criteria: non-English speaking contra-indications for transdermal nicotine in recovery for pathological gambling

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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No

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 of Care<br>transdermal nicotine replacement [21 mg patches (4 wks), 14 mg (2 wks), 7 mg (2 wks)], breath sample monitoring, standard smoking cessation counseling | Other: Standard of Care<br>* Standard smoking cessation counseling<br>Other: Standard of Care<br>* transdermal nicotine replacement [21 mg patches (4 wks), 14 mg (2 wks), 7 mg (2 wks)]<br>Other: Standard of Care<br>* Breath sample monitoring<br>|
| Experimental: Standard of Care plus Contingency Management<br>Standard smoking cessation intervention plus contingency management | Behavioral: Contingency Management<br>* Participants earn reinforcement in the form of prizes for breath samples that test negative for cigarette smoking.<br>Other: Standard of Care<br>* Standard smoking cessation counseling<br>Other: Standard of Care<br>* transdermal nicotine replacement [21 mg patches (4 wks), 14 mg (2 wks), 7 mg (2 wks)]<br>Other: Standard of Care<br>* Breath sample monitoring<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Longest Duration of Abstinence |  | Week 4 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cigarette Smoking, Homeless, Contingency Management, Smoking Cessation