NCT02597491

Brief Summary

In this sequential, multiple assignment, randomized trial (SMART) current smokers who are eligible for lung cancer screening will be identified using the electronic medical record at the University of Minnesota and Minneapolis VA (N=1000). All participants will receive 8 weeks of evidence-based first-line smoking cessation treatment. Participants will be eligible for three potential randomizations during one year of smoking intervention: 1) to timing of identifying early response to treatment at 4 vs. 8 weeks (all participants), 2) to telephone-based tobacco longitudinal care (TLC) vs. TLC plus pharmacist-administered Medication Therapy Management (incomplete responders to first-line treatment, Primary Aim), and 3) to monthly TLC contact vs. quarterly TLC contact (complete responders to first-line treatment, Secondary Aim). The primary outcome will be 6 months of prolonged abstinence measured 18 months after the beginning of treatment.

Trial Health

100
On Track

Trial Health Score

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

Enrollment
1,000

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Dec 2015

Longer than P75 for not_applicable

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

October 28, 2015

Completed
8 days until next milestone

First Posted

Study publicly available on registry

November 5, 2015

Completed
26 days until next milestone

Study Start

First participant enrolled

December 1, 2015

Completed
5.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2021

Completed
1.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2022

Completed
Last Updated

April 25, 2023

Status Verified

April 1, 2023

Enrollment Period

5.4 years

First QC Date

October 28, 2015

Last Update Submit

April 24, 2023

Conditions

Keywords

Smoking,Smoking cessationSequential, multiple assignment, randomized trials (SMART)Lung cancer screening

Outcome Measures

Primary Outcomes (1)

  • 6 months prolonged abstinence from smoking, measured 18M after randomization

    The primary (dichotomous) outcome for all analyses will be whether or not smokers achieve 6-month prolonged abstinence measured at 18 months after the baseline assessment. All analyses will be by intention-to-treat, and include all participants randomized to intervention, regardless of whether they are lost to follow-up.

    18 months

Study Arms (6)

4 wk assessment + TLC monthly

ACTIVE COMPARATOR

4 week assessment, 8 weeks of counseling, NRT, monthly follow-up (responders)

Behavioral: TLC monthlyBehavioral: 4 week assessment

4 week assessment + TLC quarterly

ACTIVE COMPARATOR

4 week assessment, 8 weeks of counseling, NRT, quarterly follow-up (responders)

Behavioral: TLC quarterlyBehavioral: 4 week assessment

4 week assessment +TLC + MTM

ACTIVE COMPARATOR

4 week assessment, 4 weeks counseling, NRT, medication management (nonresponders)

Behavioral: TLC monthlyBehavioral: MTMBehavioral: 4 week assessment

8 week assessment + TLC monthly

ACTIVE COMPARATOR

8 week assessment, 8 weeks of counseling, NRT, monthly follow-up (responders)

Behavioral: TLC monthlyBehavioral: 8 week assessment

8 week assessment + TLC quarterly

ACTIVE COMPARATOR

8 week assessment, 8 weeks of counseling, NRT, quarterly follow-up (responders)

Behavioral: TLC quarterlyBehavioral: 8 week assessment

8 week assessment + TLC + MTM

ACTIVE COMPARATOR

8 week assessment, 8 weeks counseling, NRT, medication management (nonresponders)

Behavioral: TLC monthlyBehavioral: MTMBehavioral: 8 week assessment

Interventions

TLC monthlyBEHAVIORAL

Tobacco longitudinal care monthly

4 week assessment +TLC + MTM4 wk assessment + TLC monthly8 week assessment + TLC + MTM8 week assessment + TLC monthly
TLC quarterlyBEHAVIORAL

Tobacco longitudinal care quarterly

4 week assessment + TLC quarterly8 week assessment + TLC quarterly
MTMBEHAVIORAL

Medication management therapy

4 week assessment +TLC + MTM8 week assessment + TLC + MTM

4 week assessment

4 week assessment + TLC quarterly4 week assessment +TLC + MTM4 wk assessment + TLC monthly

8 week assessment

8 week assessment + TLC + MTM8 week assessment + TLC monthly8 week assessment + TLC quarterly

Eligibility Criteria

Age55 Years - 79 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • scheduled or has order for low dose CT screening for lung cancer, or is eligible for screening low-dose CT
  • current daily smoker (eligible smokers will have smoked during the past 30 days and on at least 5 out of the past 7 days; individuals who have made a recent quit attempt, for example, in anticipation of their low dose CT scan for lung cancer screening, will be eligible if during the last 30 days, when they were smoking regularly, they smoked on at least 5 out of 7 days of the week).
  • to 79 years old,
  • Interested in quitting and willing to choose a quit smoking date within the next 12 weeks,
  • voluntary written consent

You may not qualify if:

  • Unstable psychiatric disease, unless stable in treatment for 3 months (smokers on mental health medication with any changes in medication in past 3 months require study MD approval to participate) - Smokers with stable psychiatric disease will be eligible; this baseline characteristic and related symptoms will be considered in analyses,
  • No hospitalization for mental health reasons in past 3 months; No thoughts of self-harm in past 2 weeks,
  • No recent cognitive impairment (difficulties planning or organizing daily activities, such as managing finances, having trouble remembering appointments, or forgetting the correct month of the year); participants reporting recent cognitive impairment will be given the 6-item Callahan Cognitive Screener and must score at least a 5 out of 6 to participate,
  • Participating in a formal quit program (such as tobacco cessation counseling with or without use of NRT, bupropion, or varenicline; Smokers using NRT will be eligible as long as they are not using it as part of a formal quit program),
  • No phone
  • Non-English speaking
  • Current diagnosis of lung cancer

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (3)

  • Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003 Feb;5(1):13-25.

    PMID: 12745503BACKGROUND
  • Fu SS, Rothman AJ, Vock DM, Lindgren BR, Almirall D, Begnaud A, Melzer AC, Schertz KL, Branson M, Haynes D, Hammett P, Joseph AM. Optimizing Longitudinal Tobacco Cessation Treatment in Lung Cancer Screening: A Sequential, Multiple Assignment, Randomized Trial. JAMA Netw Open. 2023 Aug 1;6(8):e2329903. doi: 10.1001/jamanetworkopen.2023.29903.

  • Fu SS, Rothman AJ, Vock DM, Lindgren B, Almirall D, Begnaud A, Melzer A, Schertz K, Glaeser S, Hammett P, Joseph AM. Program for lung cancer screening and tobacco cessation: Study protocol of a sequential, multiple assignment, randomized trial. Contemp Clin Trials. 2017 Sep;60:86-95. doi: 10.1016/j.cct.2017.07.002. Epub 2017 Jul 4. No abstract available.

MeSH Terms

Conditions

SmokingSmoking Cessation

Interventions

Restraint, Physical

Condition Hierarchy (Ancestors)

BehaviorHealth Behavior

Intervention Hierarchy (Ancestors)

Behavior ControlTherapeuticsImmobilizationInvestigative Techniques

Study Officials

  • Anne Joseph, MD

    University of Minnesota

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 28, 2015

First Posted

November 5, 2015

Study Start

December 1, 2015

Primary Completion

May 1, 2021

Study Completion

September 30, 2022

Last Updated

April 25, 2023

Record last verified: 2023-04