Smoking Cessation Clinical Trial
Official title:
Internet-Based Smoking Cessation for OEF/OIF Veterans
The overarching aim of the study is to evaluate in a randomized trial the impact of an internet intervention compared to a standard clinic-based control group to promote smoking cessation among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans.
Project Background: Veterans returning from Iraq and Afghanistan are smoking at high rates
and are at elevated risk for the development of smoking related illness. Intensive
speciality clinic-based tobacco cessation programs have high efficacy, are more cost
effective than less intensive approaches, and are employed by most VA medical centers. These
programs, however, are infrequently attended by veterans, limiting the impact on prevalence,
disease burden, and economic costs of smoking. An internet-based smoking cessation
intervention could be an effective, low-cost method to implement evidence based smoking
cessation principles. The internet could significantly increase the impact of smoking
cessation efforts over current approaches by avoiding barriers that limit utilization of
existing clinic-based services.
Project Objectives: The goal of the study is to evaluate the impact of an internet-based
intervention in comparison to standard VA speciality clinic-based care in promoting smoking
cessation in returning veterans. Accordingly, the specific aims and hypotheses are:
AIM 1: To evaluate the impact of an internet-based smoking cessation intervention on rates
of abstinence from cigarettes (self-reported 7-day point prevalent abstinence) at 3 months
and 12-month post-treatment follow-ups.
Hypothesis 1: Abstinence rates will be significantly higher among veterans randomized to the
web-based intervention than those randomized to VA specialty cessation care.
AIM 2: To evaluate the impact of an internet-based smoking cessation intervention on reach
of smoking cessation treatment.
Hypothesis 2.1: Internet-based treatment will result in increased reach as measured by the
proportion of patients who access care. Hypothesis 2.2: Internet-based treatment will result
in engagement in treatment as measured by the proportion of patients that make at least one
quit attempt.
AIM 3: To evaluate the relative cost-effectiveness of the standard specialty care
intervention to the web-based intervention.
Project Methods: Proposed is a trial in which 410 OEF/OIF veteran smokers will be randomized
to receive either an internet-based smoking cessation intervention and nicotine replacement
therapy or referral to VA specialty smoking cessation care, which includes behavioral
therapy, group counseling, telephone counseling, self-help materials, and choice of smoking
cessation aid (pharmacotherapy).
Participating patients will be surveyed at 3 months post-intervention and at 12 months. The
primary outcome of the trial is a 7-day point prevalence abstinence at the 3-month post
intervention follow-up, as measured by self-report and verified by cotinine assay.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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