Tobacco Dependence Clinical Trial
Official title:
Prolonged Smoking Cessation Using Prescription Step Care
Smoking is the number one preventable cause of morbidity and mortality in this nation.
Unfortunately, more than 50% of those who quit following a smoking cessation intervention
typically relapse within two weeks, with approximately 80% relapsing within six months.
Therefore, tobacco use can be conceptualized as a chronic condition. As with many chronic
medical problems, tobacco use interventions may benefit from a step care approach to
treatment.
A total of 400 adult smokers will be enrolled in the study. Participants will be randomly
assigned to one of two treatment conditions consisting of: 1) A State of the Art Smoking
Cessation Intervention + Recycling or: 2) A State of the Art Smoking Cessation Intervention
+ Step Care. Long term smoking cessation will be assessed by self-report, exhaled carbon
monoxide levels, and salivary cotinine. The primary endpoint of the study will be smoking
abstinence rates at two-year follow-up. It is predicted that long-term cessation rates will
be significantly higher in the step care condition than for those assigned to the recycling
group.
A common approach to increasing long-term adherence and control of chronic medical problems
such as hypertension in both general and preventive medicine is the concept of step care.
Despite a high degree of interest in applying the step care model to smoking cessation
(Abrams et al., 1996; Hughes, 1994), little empirical work has been conducted utilizing this
treatment approach. The purpose of this study is to evaluate the long-term efficacy of a
step care model for smoking cessation that is disseminable in primary care settings. With
that introduction, we propose the following specific aims:
Aim 1: To enroll approximately 400 adult cigarette smokers recruited mainly from primary
care settings;
Aim 2: To randomize these participants to: 1) State of the Art Smoking Cessation + Recycling
or 2) State of the Art Smoking Cessation + Step Care; and
Aim 3: To evaluate the long-term (24 months post-randomization) relative success of the
interventions. It is predicted that long-term cessation rates will be significantly higher
in the step care condition.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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