NCT01087905

Brief Summary

Research shows that smoking cessation is the most significant preventable health behavior change that a person can make to lower cancer risk. In addition, telephone quitlines are an effective, science-based smoking cessation treatment that is universally accessible to smokers in the U.S. However, little research has explored promising approaches that could increase quitline use, improve quit rates, and inform resource allocation for quitline services. The proposed study will test three promising enhancements to the standard quitline treatment that typically consists of counseling and, possibly 2 weeks of a NRT medication. These enhancements are: 1) combination nicotine replacement therapy as recommended by the United States Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence; 2) extended duration of cessation medication use; and 3) an innovative counseling addition - cognitive medication adherence counseling - to optimize adherence to cessation medication. In addition, the cost-effectiveness of each intervention will be calculated. The findings of the proposed research have broad potential application and relevance to state quitlines, quitline service providers, and other purchasers of quitline services such as employers and insurers. Additionally, the study findings can potentially inform other telephone health behavior counseling programs.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
987

participants targeted

Target at P75+ for phase_4

Timeline
Completed

Started Apr 2010

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 15, 2010

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 16, 2010

Completed
16 days until next milestone

Study Start

First participant enrolled

April 1, 2010

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2011

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2011

Completed
1.5 years until next milestone

Results Posted

Study results publicly available

April 24, 2013

Completed
Last Updated

December 8, 2016

Status Verified

October 1, 2016

Enrollment Period

10 months

First QC Date

March 15, 2010

Results QC Date

January 30, 2013

Last Update Submit

October 26, 2016

Conditions

Keywords

SmokingSmoking cessationMedication adherence

Outcome Measures

Primary Outcomes (2)

  • 7-Day Point Prevalence Abstinence From Smoking by Intervention

    Self-reported total abstinence from any tobacco use (even a single puff) for the seven days preceding the target follow-up day.

    26 weeks after the target quit smoking date

  • 7-Day Point Prevalence Abstinence From Smoking by Nicotine Replacement Therapy (NRT) Group

    Self-reported total abstinence from any tobacco use (even a single puff) for the seven days preceding the target follow-up day.

    26 weeks after the target quit smoking date

Secondary Outcomes (1)

  • Incremental Cost-Effectiveness Ratio for 7-Day Point Prevalence Abstinence From Smoking at 26 Weeks Post-Quit by Nicotine Replacement Therapy (NRT) Group

    26 weeks after the target quit smoking date

Study Arms (8)

2 Weeks of Nicotine Patch Only, No CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 2 weeks of nicotine patch and standard cessation counseling (but no Cognitive Medication Adherence Counseling) 2 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 2 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 2 weeks

Drug: Nicotine patch

2 Weeks of Nicotine Patch Only plus CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 2 weeks of nicotine patch and standard cessation counseling plus Cognitive Medication Adherence Counseling 2 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 2 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 2 weeks

Drug: Nicotine patchBehavioral: CMAC

2 Wks Nicotine Patch+Nic Gum, No CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 2 weeks of nicotine patch plus nicotine gum and standard cessation counseling (but no Cognitive Medication Adherence Counseling) 2 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 2 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 2 weeks 2 Weeks of Nicotine gum dosed as follows: If \< 25 cigs/day, 2 mg nicotine gum for 2 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects. If ≥ 25 cigs/day, 4 mg nicotine gum for 2 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects.

Drug: Nicotine patchDrug: Nicotine gum

2 Wks Nicotine Patch+Nic Gum plus CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 2 weeks of nicotine patch and nicotine gum plus standard cessation counseling and Cognitive Medication Adherence Counseling 2 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 2 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 2 weeks 2 Weeks of Nicotine gum dosed as follows: If \< 25 cigs/day, 2 mg nicotine gum for 2 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects. If ≥ 25 cigs/day, 4 mg nicotine gum for 2 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects.

Drug: Nicotine patchDrug: Nicotine gumBehavioral: CMAC

6 Weeks of Nicotine Patch Only, No CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 6 weeks of nicotine patch and standard cessation counseling (but no Cognitive Medication Adherence Counseling) 6 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 6 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 6 weeks

Drug: Nicotine patch

6 Weeks of Nicotine Patch Only plus CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 6 weeks of nicotine patch and standard cessation counseling plus Cognitive Medication Adherence Counseling 6 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 6 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 6 weeks

Drug: Nicotine patchBehavioral: CMAC

6 Wks Nicotine Patch+Nic Gum, No CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 6 weeks of nicotine patch plus nicotine gum and standard cessation counseling (but no Cognitive Medication Adherence Counseling) 6 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 6 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 6 weeks 6 Weeks of Nicotine gum dosed as follows: If \< 25 cigs/day, 2 mg nicotine gum for 6 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects. If ≥ 25 cigs/day, 4 mg nicotine gum for 6 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects.

Drug: Nicotine patchDrug: Nicotine gum

6 Wks Nicotine Patch+Nic Gum plus CMAC

ACTIVE COMPARATOR

Participants in this randomization arm received 6 weeks of nicotine patch and nicotine gum plus standard cessation counseling and Cognitive Medication Adherence Counseling 6 Weeks of Nicotine patch dosed as follows: If \> 10 cigs/day: one 21 mg nicotine patch per day for 6 weeks If \< or = 10 cigs/day: one 14 mg nicotine patch per day for 6 weeks 6 Weeks of Nicotine gum dosed as follows: If \< 25 cigs/day, 2 mg nicotine gum for 6 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects. If ≥ 25 cigs/day, 4 mg nicotine gum for 6 weeks, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects.

Drug: Nicotine patchDrug: Nicotine gumBehavioral: CMAC

Interventions

If \> 10 cigs/day: one 21 mg nicotine patch per day If \< or = 10 cigs/day: one 14 mg nicotine patch per day

2 Weeks of Nicotine Patch Only plus CMAC2 Weeks of Nicotine Patch Only, No CMAC2 Wks Nicotine Patch+Nic Gum plus CMAC2 Wks Nicotine Patch+Nic Gum, No CMAC6 Weeks of Nicotine Patch Only plus CMAC6 Weeks of Nicotine Patch Only, No CMAC6 Wks Nicotine Patch+Nic Gum plus CMAC6 Wks Nicotine Patch+Nic Gum, No CMAC

If \< 25 cigs/day, 2 mg nicotine gum, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects. If ≥ 25 cigs/day, 4 mg nicotine gum, at least 5 pieces of oral NRT per day (maximum of 1 piece every 1-2 hours), unless this amount of use produces nicotine toxicity effects.

Also known as: Nicotine polacrilex
2 Wks Nicotine Patch+Nic Gum plus CMAC2 Wks Nicotine Patch+Nic Gum, No CMAC6 Wks Nicotine Patch+Nic Gum plus CMAC6 Wks Nicotine Patch+Nic Gum, No CMAC
CMACBEHAVIORAL

CMAC consists of tailored cessation counseling to improve medication adherence during the counseling calls. The CMAC protocol was developed by study investigators and involved: (1) pre-quit assessment of beliefs that might undermine NRT adherence; (2) on-going medication adherence assessment by quitline Quit Coaches; and (3) tailored coaching based on the ongoing assessments.

Also known as: Cognitive Medication Adherence Counseling
2 Weeks of Nicotine Patch Only plus CMAC2 Wks Nicotine Patch+Nic Gum plus CMAC6 Weeks of Nicotine Patch Only plus CMAC6 Wks Nicotine Patch+Nic Gum plus CMAC

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Callers will be eligible to participate in the study if they are English speaking; are 18 years of age or older; smoke a minimum of 10 cigarettes per day; are interested in quitting and are willing to set a quit date; willing and able to use nicotine patch and nicotine gum; agree to receive four follow-up counseling calls from Free \& Clear (the quitline vendor for the State of Wisconsin); provide verbal informed consent; and provide contact information and agree to take four study follow-up calls from staff at the University of Wisconsin Center for Tobacco Research and Intervention.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Wisconsin Tobacco Quit Line (service provided by Free & Clear, Inc.)

Seattle, Washington, 98104, United States

Location

University of Wisconsin Center for Tobacco Research and Intervention

Madison, Wisconsin, 53711, United States

Location

Related Publications (1)

  • Smith SS, Keller PA, Kobinsky KH, Baker TB, Fraser DL, Bush T, Magnusson B, Zbikowski SM, McAfee TA, Fiore MC. Enhancing tobacco quitline effectiveness: identifying a superior pharmacotherapy adjuvant. Nicotine Tob Res. 2013 Mar;15(3):718-28. doi: 10.1093/ntr/nts186. Epub 2012 Sep 19.

Related Links

MeSH Terms

Conditions

SmokingSmoking CessationMedication Adherence

Interventions

Tobacco Use Cessation DevicesNicotine Chewing Gum

Condition Hierarchy (Ancestors)

BehaviorHealth BehaviorPatient CompliancePatient Acceptance of Health CareTreatment Adherence and Compliance

Intervention Hierarchy (Ancestors)

TherapeuticsChewing GumPlant GumsBiopolymersPolymersMacromolecular SubstancesPolysaccharidesCarbohydratesCandyFoodDiet, Food, and NutritionPhysiological PhenomenaFood and Beverages

Results Point of Contact

Title
Stevens S. Smith, Ph.D.
Organization
University of Wisconsin School of Medicine and Public Health

Study Officials

  • Stevens S Smith, PhD

    University of Wisconsin Center for Tobacco Research and Intervention, School of Medicine and Public Health

    PRINCIPAL INVESTIGATOR
  • Paula A Keller, MPH

    University of Wisconsin Center for Tobacco Research and Intervention, School of Medicine and Public Health

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 15, 2010

First Posted

March 16, 2010

Study Start

April 1, 2010

Primary Completion

February 1, 2011

Study Completion

November 1, 2011

Last Updated

December 8, 2016

Results First Posted

April 24, 2013

Record last verified: 2016-10

Data Sharing

IPD Sharing
Will share

Upon request, clinical trial data will be shared with other investigators in the form of de-identified datasets. Requests can be sent to Stevens S. Smith, Ph.D., at sss@ctri.wisc.edu

Locations