Smoking, Smoking, Tobacco, Tobacco Use Disorder
Conditions
Keywords
Inpatients
Brief summary
The investigators plan to compare the impact of two approaches for smoking cessation on smoking abstinence, use of evidenced-based therapy, and quality of life among a diverse population of patients at the Manhattan campus of the VA New York Harbor Healthcare System, which serves a critical safety-net role for urban veterans. During hospitalization, all smokers will receive usual care. Patients will be randomized to one of two arms: financial incentives plus usual care vs. usual care alone, which includes referral to the state Quitline. All patients enrolled in the study will be offered nicotine replacement therapy. The investigators will conduct follow-up assessments at 2 weeks, 2 months, 6 months and 12 months after discharge. The primary study outcome is smoking abstinence at 6-month follow-up, verified by salivary/urinary cotinine.
Interventions
BEHAVIORALSmoking cessation counseling (Quitline)
BEHAVIORALFinancial incentives
Sponsors
Robert Wood Johnson Foundation
University of California, Los Angeles
NYU Langone Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. age ≥ 18 years, 2. smoked tobacco during the prior 30 days, 3. have an active U.S. phone number and address, 4. can provide consent in English and 5. are in at least the contemplative stage of change for quitting smoking, as assessed by a single measure, readiness to quit
Exclusion criteria
1. use only smokeless tobacco, 2. are pregnant or breastfeeding, 3. are discharged to an institution (e.g., nursing home, long-term care facility), 4. are unable to provide informed consent, or do not have cognitive ability to enroll or participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Smoking abstinence assessed by self-reported and biochemically verified by salivary cotinine | 6 months | Assessed by self-report questionnaire, and biochemically verified by salivary cotinine |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Smoking abstinence assessed by self-report | 6 months | Assessed by self-report questionnaire |
| Use of evidence based treatment (e.g. counseling and smoking cessation medications) assessed by discharge prescriptions, Quitline records, receipts, letters and/or self-report | 2 weeks and 2 months | Assessed by discharge prescriptions, Quitline records, receipts, letters and/or self-report |
| Quality of life as measured by the EQ5-D and VR-12 | 6 months | As measured by the EQ5-D and VR-12 |
| Short term return on investment of using financial incentives to promote smoking cessation (Cost analysis) | 12 months | Cost analysis involving hospital utilization data, electronic health records and patient-reported healthcare utilization |
| Long term return on investment of using financial incentives to promote smoking cessation (Cost analysis) | 3 years | Cost analysis involving hospital utilization data, electronic health records and patient-reported healthcare utilization |
Countries
United States
Outcome results
None listed