NCT04798664

Brief Summary

To compare the effectiveness of four interventions to promote sustained, biochemically confirmed smoking abstinence for 6 months among underserved smokers referred for lung cancer screening at four large U.S. health systems.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
3,228

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

5 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 11, 2021

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 15, 2021

Completed
2 months until next milestone

Study Start

First participant enrolled

May 17, 2021

Completed
3.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 4, 2024

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 29, 2025

Completed
10 months until next milestone

Results Posted

Study results publicly available

February 25, 2026

Completed
Last Updated

February 25, 2026

Status Verified

February 1, 2026

Enrollment Period

3.5 years

First QC Date

March 11, 2021

Results QC Date

October 21, 2025

Last Update Submit

February 23, 2026

Conditions

Keywords

Patients, UnderservedEarly Detection of CancerLung CancerNicotine Replacement ProductsIncentivesBehavioral EconomicsSmoking CessationNicotine Dependence

Outcome Measures

Primary Outcomes (1)

  • Biochemically Confirmed Smoking Abstinence Sustained for 6 Months

    The primary outcome measure is sustained abstinence for 6 months, and will require self-report of smoking cessation followed by biochemical confirmation at 2 weeks, 3, and 6 months.

    6 months

Secondary Outcomes (18)

  • Quit Status (Biochemically Confirmed)

    2 weeks, 3 months, 12 months

  • Health-related Quality of Life

    Baseline

  • Perceived Barriers to Cessation

    Baseline

  • Self-efficacy Related to Cessation Efforts

    Baseline

  • Motivation to Quit

    Baseline

  • +13 more secondary outcomes

Study Arms (4)

Basic Usual Care

NO INTERVENTION

Participants receive the usual care approach, Ask-Advise-Refer (AAR), which is a standard approach in which non-study clinicians ask smokers about their desire to quit smoking, advise them to quit, and provide informational resources such as hotlines, specialized clinics, or smoking cessation classes.

Enhanced Usual Care

ACTIVE COMPARATOR

Participants receive the basic usual care of Ask-Advise-Refer as well as free access to nicotine replacement therapy (NRT) and/or reimbursement of up to $300 for any smoking cessation medications (varenicline/Chantix or bupropion/Zyban) prescribed by non-study clinicians.

Behavioral: Removal of Financial Barriers

Enhanced Usual Care plus Financial Incentives

ACTIVE COMPARATOR

Participants receive all aspects of enhanced usual care plus an incentive plan in which they will be informed of their eligibility to earn $100, $200, and $300 if they submit negative tests for nicotine metabolites at 2 weeks, 3 month and 6 months following their quit date, respectively.

Behavioral: Removal of Financial BarriersBehavioral: Financial Incentives

Enhanced Usual Care plus Financial Incentives plus Mobile Health Application

ACTIVE COMPARATOR

Participants receive all aspects of Arm 3 plus an intervention to promote episodic future thinking (EFT), called FutureMe. EFT has been shown to reliably reduce discounting of the future. Patients will practice using EFT cues to envision the "future is now" between the time of enrollment and the quit date, and will then receive cues from the quit date through the end of the intervention period, 6 months later, unless they ask to stop receiving cues sooner.

Behavioral: Removal of Financial BarriersBehavioral: Financial IncentivesBehavioral: Mobile Health Application

Interventions

Episodic future thinking tool to overcome temporal discounting of future

Also known as: FutureMe
Enhanced Usual Care plus Financial Incentives plus Mobile Health Application

Free access to nicotine replacement therapies and/or reimbursement for smoking cessation prescription medications

Also known as: NRT, Pharmacotherapy
Enhanced Usual CareEnhanced Usual Care plus Financial IncentivesEnhanced Usual Care plus Financial Incentives plus Mobile Health Application

Financial incentive plan of up to $600 for biochemically-confirmed, sustained abstinence for 6 months.

Also known as: Incentives
Enhanced Usual Care plus Financial IncentivesEnhanced Usual Care plus Financial Incentives plus Mobile Health Application

Eligibility Criteria

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

You may qualify if:

  • Current smoker (≥ 1 cigarettes per day, not including e-cigarettes)
  • Has a low-dose computed tomography (LDCT) scan ordered by their physician
  • Underserved, defined as one or more of the following: (a) Black, (b) Hispanic, (c) rural residence, or (d) low socioeconomic status (Defined as one or both of: high-school education or less, or household income \<200% of the federal poverty line)
  • Able to receive study invitation and screening, by virtue of showing up to a radiology location affiliated with a participating health system for the LDCT, or having a valid email address or telephone number on file with the health system
  • Access to a cell phone with text messaging or the internet
  • Aged 18 years or older

You may not qualify if:

  • No cell phone

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Kaiser Permanente Southern California

Oakland, California, 94612, United States

Location

Henry Ford Health System

Detroit, Michigan, 48202, United States

Location

Geisinger

Danville, Pennsylvania, 17822, United States

Location

Lancaster General Health

Lancaster, Pennsylvania, 17601, United States

Location

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

  • Kohn R, Vachani A, Small D, Stephens-Shields AJ, Sheu D, Madden VL, Bayes BA, Chowdhury M, Friday S, Kim J, Gould MK, Ismail MH, Creekmur B, Facktor MA, Collins C, Blessing KK, Neslund-Dudas CM, Simoff MJ, Alleman ER, Epstein LH, Horst MA, Scott ME, Volpp KG, Halpern SD, Hart JL; Stakeholder Advisory Committee. Comparing Smoking Cessation Interventions among Underserved Patients Referred for Lung Cancer Screening: A Pragmatic Trial Protocol. Ann Am Thorac Soc. 2022 Feb;19(2):303-314. doi: 10.1513/AnnalsATS.202104-499SD.

MeSH Terms

Conditions

Smoking CessationLung NeoplasmsTobacco Use Disorder

Interventions

Drug TherapyFertility

Condition Hierarchy (Ancestors)

Health BehaviorBehaviorRespiratory Tract NeoplasmsThoracic NeoplasmsNeoplasms by SiteNeoplasmsLung DiseasesRespiratory Tract DiseasesSubstance-Related DisordersChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

TherapeuticsReproductive Physiological PhenomenaReproductive and Urinary Physiological Phenomena

Results Point of Contact

Title
Shira Blady
Organization
University of Pennsylvania

Study Officials

  • Scott D Halpern, MD PhD

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This is a prospective randomized controlled trial using opt-out consent with longitudinal follow-up of patients over 12 months. Based on the expected accrual at each of the four health systems, we expect that overall there will be 470 participants in basic usual care (Arm 1), and 910 participants in each of intervention arms 2-4.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 11, 2021

First Posted

March 15, 2021

Study Start

May 17, 2021

Primary Completion

November 4, 2024

Study Completion

April 29, 2025

Last Updated

February 25, 2026

Results First Posted

February 25, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

Individual participant data that underlie published results will be made available to other researchers, after de-identification.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
Beginning 9 months after publication and up to 36 months following publication. After 36 months the data will be available in our University's data warehouse but without support, except for deposited metadata.
Access Criteria
Proposals for data use will be reviewed by Principal Investigator and independent review board (such as the Data and Safety Monitoring Board). Approved requestors will need to sign data use agreements to access and use data.
More information

Locations