Nicotine Dependence Clinical Trial
Official title:
Tobacco Cessation:Treatment Delivery and Predictors of Outcome
Background:
- The success rate for those who attempt to quit using tobacco products is only about 5
percent. Many people who try to quit do so without seeking professional help. Several kinds
of nicotine replacement therapy (NRT) are available without a prescription. However,
prescription drugs and mental health counseling can also help people stop using tobacco.
Combining NRT and/or medication with counseling can increase success rates. Researchers want
to study what kinds of tobacco cessation treatments are most successful. This may help
develop better treatments and determine who will respond best to them.
Objectives:
- To provide treatment for tobacco use.
- To identify factors that affect how well people respond to treatment.
Eligibility:
- Individuals at least 18 years of age who are trying to stop using tobacco products.
Design:
- This study will last up to 1 year. Treatment may last up to 36 weeks. Treatment may
include counseling, NRT (patches and/or nicotine lozenges), or prescription medication
(varenicline or bupropion). Treatment will be determined by a study doctor.
- Participants will also have three study visits at 4, 6, and 12 months after starting
treatment. Each visit may take up to 2 hours. At the study visits, participants will
have different kinds of tests. They will provide blood and urine samples, and have
carbon monoxide breath tests. They will also fill out forms about mood and tobacco
cravings.
- During treatment, participants will have clinic visits once or twice a week for
counseling and to monitor tobacco use and withdrawal symptoms. Counseling sessions will
work on dealing with tobacco cravings. Each visit may take up to 90 minutes.
Objective
The purpose of this protocol is to create a mechanism whereby the intramural program of the
NIDA in Baltimore, MD can evaluate and treat a broad range of people who use tobacco
products. Through this protocol, participants will receive state-of-the-art treatment for
their tobacco use. The secondary objective is to investigate predictors of success in
tobacco-use-cessation treatment.
Study population
Participants will be individuals who present to the NIDA IRP seeking to quit tobacco use
(smoked and smokeless). Enrollment may occur as part of participation in another NIDA IRP
study. We will enroll up to 1000 participants. All individuals who give signed informed
consent and who attend at least one study visit will be considered evaluable. We will not
replace study dropouts.
Design
After undergoing initial screening and signing the IRB-approved consent form, participants
will be enrolled in our outpatient smoking treatment-research clinic at the NIDA IRP. The
study will last up to one year, with active treatment lasting up to 36 weeks and follow-up
visits 4, 6, and 12 months after the first treatment visit. Treatment will include counseling
and pharmacotherapy (nicotine replacement, bupropion, or varenicline, if warranted and
medically appropriate). During active treatment, participants will visit the clinic up to
twice a week for counseling, dispensing of medication, and monitoring of tobacco use,
withdrawal symptoms, and reporting of any adverse events. Visits may take up to 90 minutes.
Outcome measures
There are no outcome measures for the primary objective. For the secondary objectives, the
outcome measures are (1) tobacco abstinence, as determined by self-reported tobacco use,
urinary cotinine, and (in tobacco smokers only) breath CO, and (2) reduction in tobacco use
of at least 50% (e.g., from 10 cigarettes per day to 5 cigarettes per day). Other outcome
measures for the secondary objectives include duration of abstinence, nicotine withdrawal
signs and symptoms, and tobacco craving. Behavioral, psychological, medical, and genetic
characteristics and tobacco-use history will be assessed at the beginning of the study as
predictors of treatment outcome and at follow-up.
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