Cancer Control Research
5R01CA071378-04
Hall, Sharon M.
BRIEF VERSUS EXTENDED SMOKING TREATMENT
AbstractDESCRIPTION: (Applicant's Description) The overall goals of this smoking
cessation research are: 1) to understand the factors causing relapse to
cigarettes, and 2) to design and evaluate treatments based on that
understanding. In a 2 X 2 factorial design, where all subjects are
receiving nicotine gum, the proposed research will test a series of
hypotheses about the clinical efficacy, the cost, and the cost effectiveness
of brief versus extended treatment, and of medical management alone versus
medical management plus psychosocial support. In the brief treatment
conditions, subjects will be treated for three months. In the extended
treatment conditions, subjects will be treated for one year, which will
include year long access to nicotine gum. This study has three interrelated
foci: The first is to determine the relative efficacy of brief versus
extended treatment in assisting smoking cessation; the second is to
determine the relative efficacy of the two levels of psychosocial
intervention (medical management alone vs. medical management plus
psychosocial support) in assisting smoking cessation; and the third is to
compare the cost and the cost effectiveness of these treatments. A total of
360 nicotine dependent individuals who are applying for smoking cessation
treatment will be stratified by number of cigarettes smoked, past treatment
failure using nicotine replacement therapy versus not, and on history of
depression versus not, and randondy assigned from the stratified blocks to
receive one of the four treatment conditions. A complete instrument battery
will be done at baseline (Week 0); further assessments will be completed at
brief treatment termination (Week 12), 6 months (Week 24), 9 months (Week
36), and one year (Week 52). Variables assessed are smoking behavior and
biochemically verified smoking status, diagnosis, demographics and treatment
history, state and trait measures of mood, support for quitting smoking,
cigarette craving, and medication side effects. The cost effectiveness of
the treatment conditions will be determined. If funded, this study will
provide data about the efficacy and the cost effectiveness of treatments for
smoking cessation based on rigorously designed clinical experiments. These
data have implications for treatment providers and policy makers.
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