Journal article
A smoking cessation intervention for rural veterans tailored to individual risk factors: A multicenter randomized clinical trial
Journal of Substance Use and Addiction Treatment, Vol.156, 209191
01/2024
DOI: 10.1016/j.josat.2023.209191
PMCID: PMC11700485
PMID: 37866436
Abstract
Introduction
Rates of cigarette use remain elevated among those living in rural areas. Depressive symptoms, risky alcohol use, and weight concerns frequently accompany cigarette smoking and may adversely affect quitting. Whether treatment for tobacco use that simultaneously addresses these issues affects cessation outcomes is uncertain.
Methods
The study was a multicenter, two-group, randomized controlled trial involving mostly rural veterans who smoke (N = 358) receiving treatment at one of five Veterans Affairs Medical Centers. The study randomly assigned participants to a tailored telephone counseling intervention or referral to their state tobacco quitline. Both groups received guideline-recommended smoking cessation pharmacotherapy, selected using a shared decision-making approach. The primary outcome was self-reported seven-day point prevalence abstinence (PPA) at three and six months. The study used salivary cotinine to verify self-reported quitting at six months.
Results
Self-reported PPA was significantly greater in participants assigned to Tailored Counseling at three (OR = 1.66; 95 % CI: 1.07–2.58) but not six (OR = 1.35; 95 % CI: 0.85–2.15) months. Post hoc subgroup analyses examining treatment group differences based on whether participants had a positive screen for elevated depressive symptoms, risky alcohol use, and/or concerns about weight gain indicated that the cessation benefit of Tailored Counseling at three months was limited to those with ≥1 accompanying concern (OR = 2.02, 95 % CI: 1.20–3.42). Biochemical verification suggested low rates of misreporting.
Conclusions
A tailored smoking cessation intervention addressing concomitant risk factors enhanced short-term abstinence but did not significantly improve long-term quitting. Extending the duration of treatment may be necessary to sustain treatment effects.
Details
- Title: Subtitle
- A smoking cessation intervention for rural veterans tailored to individual risk factors: A multicenter randomized clinical trial
- Creators
- Mark W. Vander WegM. Bryant Howren - Iowa City VA Health Care SystemKathleen M. Grant - University of Nebraska Medical CenterAllan V. Prochazka - VA Eastern Colorado Health Care SystemSonia Duffy - VA Center for Clinical Management ResearchRandy Burke - University of MississippiMargaret Cretzmeyer - University of IowaChristopher Parker - American Association of Colleges of PharmacyEmily B.K. ThomasMarianne T. Rizk - VA St. Louis Health Care SystemJennifer BayerEllen M. Kinner - University of IowaJennifer M. Clark - University of IowaDavid A. Katz - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Journal of Substance Use and Addiction Treatment, Vol.156, 209191
- DOI
- 10.1016/j.josat.2023.209191
- PMID
- 37866436
- PMCID
- PMC11700485
- NLM abbreviation
- J Subst Use Addict Treat
- ISSN
- 2949-8759
- Language
- English
- Electronic publication date
- 10/2023
- Date published
- 01/2024
- Academic Unit
- Epidemiology; Psychological and Brain Sciences; School of Social Work; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984487653002771
Metrics
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