An Individually-tailored Smoking Cessation Intervention for Rural Veterans: a Pilot Randomized Trial

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2016 Aug 19

PMID 27535024

Citations 12

Authors

Mark W Vander Weg

Ashley J Cozad

M Bryant Howren

Margaret Cretzmeyer

Melody Scherubel

Carolyn Turvey

Kathleen M Grant

Thad E Abrams

David A Katz

Affiliations

Soon will be listed here.

Abstract

Background: Tobacco use remains prevalent among Veterans of military service and those residing in rural areas. Smokers frequently experience tobacco-related issues including risky alcohol use, post-cessation weight gain, and depressive symptoms that may adversely impact their likelihood of quitting and maintaining abstinence. Telephone-based interventions that simultaneously address these issues may help to increase treatment access and improve outcomes.

Methods: This study was a two-group randomized controlled pilot trial. Participants were randomly assigned to an individually-tailored telephone tobacco intervention combining counseling for tobacco use and related issues including depressive symptoms, risky alcohol use, and weight concerns or to treatment provided through their state tobacco quitline. Selection of pharmacotherapy was based on medical history and a shared decision interview in both groups. Participants included 63 rural Veteran smokers (mean age = 56.8 years; 87 % male; mean number of cigarettes/day = 24.7). The primary outcome was self-reported 7-day point prevalence abstinence at 12 weeks and 6 months.

Results: Twelve-week quit rates based on an intention-to-treat analysis did not differ significantly by group (Tailored = 39 %; Quitline Referral = 25 %; odds ratio [OR]; 95 % confidence interval [CI] = 1.90; 0.56, 5.57). Six-month quit rates for the Tailored and Quitline Referral conditions were 29 and 28 %, respectively (OR; 95 % CI = 1.05; 0.35, 3.12). Satisfaction with the Tailored tobacco intervention was high.

Conclusions: Telephone-based treatment that concomitantly addresses other health-related factors that may adversely affect quitting appears to be a promising strategy. Larger studies are needed to determine whether this approach improves cessation outcomes.

Trial Registration: ClinicalTrials.gov identifier number NCT01592695 registered 11 April 2012.

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References

Paxton A, Strycker L, Toobert D, Ammerman A, Glasgow R . Starting the conversation performance of a brief dietary assessment and intervention tool for health professionals. Am J Prev Med. 2010; 40(1):67-71. DOI: 10.1016/j.amepre.2010.10.009. View

Kroenke K, Spitzer R, Williams J . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606-13. PMC: 1495268. DOI: 10.1046/j.1525-1497.2001.016009606.x. View

Topolski T, LoGerfo J, Patrick D, Williams B, Walwick J, Patrick M . The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006; 3(4):A118. PMC: 1779282. View

. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002; 4(2):149-59. DOI: 10.1080/14622200210123581. View

Toll B, Martino S, OMalley S, Fucito L, McKee S, Kahler C . A randomized trial for hazardous drinking and smoking cessation for callers to a quitline. J Consult Clin Psychol. 2014; 83(3):445-54. PMC: 5996380. DOI: 10.1037/a0038183. View

Noonan D, Jiang Y, Duffy S . Utility of biochemical verification of tobacco cessation in the Department of Veterans Affairs. Addict Behav. 2012; 38(3):1792-5. PMC: 4856005. DOI: 10.1016/j.addbeh.2012.11.006. View

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-95. DOI: 10.1001/archinte.158.16.1789. View

McDonald P . Population-based recruitment for quit-smoking programs: an analytic review of communication variables. Prev Med. 1999; 28(6):545-57. DOI: 10.1006/pmed.1998.0479. View

Stead L, Hartmann-Boyce J, Perera R, Lancaster T . Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2013; (8):CD002850. DOI: 10.1002/14651858.CD002850.pub3. View

10.

Sobell L, Maisto S, Sobell M, Cooper A . Reliability of alcohol abusers' self-reports of drinking behavior. Behav Res Ther. 1979; 17(2):157-60. DOI: 10.1016/0005-7967(79)90025-1. View

11.

Duffy S, Kilbourne A, Austin K, Dalack G, Woltmann E, Waxmonsky J . Risk of smoking and receipt of cessation services among veterans with mental disorders. Psychiatr Serv. 2012; 63(4):325-32. PMC: 3323716. DOI: 10.1176/appi.ps.201100097. View

12.

Unutzer J, Katon W, Callahan C, Williams Jr J, Hunkeler E, Harpole L . Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002; 288(22):2836-45. DOI: 10.1001/jama.288.22.2836. View

13.

Hunkeler E, Katon W, Tang L, Williams Jr J, Kroenke K, Lin E . Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ. 2006; 332(7536):259-63. PMC: 1360390. DOI: 10.1136/bmj.38683.710255.BE. View

14.

Hollis J, McAfee T, Fellows J, Zbikowski S, Stark M, Riedlinger K . The effectiveness and cost effectiveness of telephone counselling and the nicotine patch in a state tobacco quitline. Tob Control. 2007; 16 Suppl 1:i53-9. PMC: 2598511. DOI: 10.1136/tc.2006.019794. View

15.

Bush T, Levine M, Deprey M, Cerutti B, Zbikowski S, McAfee T . Prevalence of Weight Concerns and Obesity Among Smokers Calling a Quitline. J Smok Cessat. 2010; 4(5):74-78. PMC: 2884159. DOI: 10.1375/jsc.4.2.74. View

16.

Enggasser J, Hermos J, Rubin A, Lachowicz M, Rybin D, Brief D . Drinking goal choice and outcomes in a Web-based alcohol intervention: results from VetChange. Addict Behav. 2015; 42:63-8. PMC: 4390170. DOI: 10.1016/j.addbeh.2014.10.036. View

17.

Nohlert E, Ohrvik J, Helgason A . Effectiveness of proactive and reactive services at the Swedish National Tobacco Quitline in a randomized trial. Tob Induc Dis. 2014; 12(1):9. PMC: 4059482. DOI: 10.1186/1617-9625-12-9. View

18.

Maisto S, Sobell M, Sobell L . Reliability of self-reports of low ethanol consumption by problem drinkers over 18 months of follow-up. Drug Alcohol Depend. 1982; 9(4):273-8. DOI: 10.1016/0376-8716(82)90066-7. View

19.

Atkins D, Clancy C . Multiple risk factors interventions. Are we up to the challenge?. Am J Prev Med. 2004; 27(2 Suppl):102-3. DOI: 10.1016/j.amepre.2004.04.016. View

20.

LaRose J, Tate D, Gorin A, Wing R . Preventing weight gain in young adults: a randomized controlled pilot study. Am J Prev Med. 2010; 39(1):63-8. PMC: 3029025. DOI: 10.1016/j.amepre.2010.03.011. View