The project is designed to examine the effectiveness of strategies to increase access to treatment for tobacco use and dependence among rural Veteran smokers. In addition, it will examine whether tailored treatment that is designed to address common comorbid conditions that are related to cigarette smoking enhances success with quitting relative to enhanced standard of care. The investigators hypothesize that participants assigned to the tailored tobacco cessation intervention will report greater cessation rates at six months. The investigators also anticipate more favorable outcomes on measures of depressive symptoms, alcohol use, and body weight.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
411
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Medication selection will be determined based on individual participant preferences, medical history, and contraindications.
Participants assigned to this condition will receive a referral to their state tobacco quitline. The specific behavioral treatment that is provided will differ slightly depending upon the services available through the participant's state of residence.
Participants will receive a standard six session cognitive behavioral intervention for smoking cessation combined with supplemental treatment modules based on individual need and preference.
Participants engaging in risky alcohol use may receive this six-session telephone-based behavioral intervention for reducing alcohol use.
Participants with elevated depressive symptoms may receive this six-session telephone-based behavioral activation intervention.
Participants with concerns about gaining weight after quitting smoking may receive this six-session telephone-based behavioral self-management intervention designed to help attenuate post-cessation weight gain.
Iowa City VA Healthcare System
Iowa City, Iowa, United States
Tobacco use
At the six-month follow-up contact, participants will be questioned regarding self-reported tobacco use over the past seven and 30 days.
Time frame: Six-month follow-up
Alcohol use
Alcohol use during the previous seven days will be assessed at the six month follow-up. Based on this information, several metrics of alcohol consumption will be obtained including: 1) average number of drinking days per week, 2) average number of drinks per drinking day, 3) number of drinks per week 4) number of heavy drinking days, and 5) maximum drinks consumed on a single occasion.
Time frame: Six-month follow-up
Depressive symptoms
Depressive symptoms will be assessed at the six-month follow-up using the Patient Health Questionnaire 9 (PHQ-9).
Time frame: Six-month follow-up
Body weight
Change in body weight will be assessed via self-report and chart review at the six-month follow-up.
Time frame: Six-month follow-up
Physical Activity
Physical activity will be assessed by self-report at the six-month follow-up visit using the Rapid Assessment of Physical Activity (RAPA).
Time frame: Six-month follow-up
Dietary intake
Self-reported dietary intake will be measured at six months using the Starting the Conversation - Diet questionnaire.
Time frame: Six-month follow-up
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