Treating Tobacco Dependence in Inpatient Psychiatry - 1
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Purpose
The purpose of this study is to test in a randomized clinical trial (N=300) a series of hypotheses concerning the efficacy of an extended expert-system intervention plus nicotine replacement therapy (NRT) for treating tobacco dependence among patients hospitalized on a smoke-free psychiatric unit. It is hypothesized that the intervention will be more effective than the enhanced standard care control condition (on-unit NRT with self-help brochure) in producing biochemically verified abstinence from cigarettes at 3-, 6-, 12-, and 18-months follow up. Additionally, intervention participants will exhibit greater stage progression, commitment to abstinence, and delay in relapse to smoking following hospital discharge, factors predictive of future success with quitting smoking. Smoking cessation treatments have been shown to be highly cost-effective with the general population of smokers, and cost is likely to be a consideration in efforts to incorporate additional services into an inpatient psychiatric setting. Therefore, a secondary specific aim is to model the cost-effectiveness of the smoking cessation intervention. Intervention efficacy will be examined in a university-based psychiatric inpatient unit. A smaller pilot study (N=48) will examine translation of the intervention to a county hospital serving a more diversified patient population.
| Condition | Intervention | Phase |
|---|---|---|
|
Tobacco Use Cessation Tobacco Use Disorder |
Behavioral: Tobacco Use Cessation |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Treating Tobacco Dependence in Inpatient Psychiatry |
- 7 day point prevalence of cigarette abstinence [ Time Frame: 1 week, 3 mo, 6 mo, 12 mo, and 18 mo post-baseline ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 300 |
| Study Start Date: | July 2006 |
| Study Completion Date: | April 2011 |
| Primary Completion Date: | April 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: 1
enhanced standard care control
|
|
|
Experimental: 2
intervention
|
Behavioral: Tobacco Use Cessation
This intervention consists of nicotine patch therapy during hospitalization; a stage-based self-help manual; an individualized, expert-system, feedback report at intake, 3 months and 6 months post-hospitalization with carbon copies sent to participants' outpatient clinicians; and an individual 30-min smoking cessation counseling sessions during hospitalization. Additionally, up to 10 weeks of nicotine patch is provided to intervention participants intending to stay quit following hospital discharge.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Men and women over 18 years of age hospitalized on an inpatient psychiatric unit who report smoking at least 5 cigarettes per day. Other inclusion criteria include: smoking at least 100 cigarettes in one's lifetime, residing in the San Francisco Bay Area with no plan to relocate outside of the area in the next 18 months, and access to a telephone for scheduling follow up assessments.
Exclusion Criteria:
Dementia or other brain injury precluding ability to participate; non-English speaking; severe agitation, psychosis, or hostility; and medical contraindications to nicotine replacement therapy (NRT). Recruitment of acutely psychotic, manic, or hostile patients will be delayed until there is significant reduction of these symptoms. Medical contraindications are: myocardial infarction in the preceding 3 months, unstable angina pectoris, liver or kidney disease, current pregnancy or breast feeding, allergies to adhesives, or other medical conditions that the medical team deems incompatible with NRT use.
Contacts and Locations| United States, California | |
| Langley Porter Psychiatric Institute | |
| San Francisco, California, United States, 94143 | |
| Principal Investigator: | Judith Prochaska | University of California, San Francisco |
More Information
No publications provided
| Responsible Party: | Judith Prochaska, PhD, MPH / Assistant Professor, UCSF |
| ClinicalTrials.gov Identifier: | NCT00136812 History of Changes |
| Other Study ID Numbers: | NIDA-18691-1, 5K23DA018691-05, K23-18691-1 |
| Study First Received: | August 25, 2005 |
| Last Updated: | April 25, 2011 |
| Health Authority: | United States: Federal Government |
Additional relevant MeSH terms:
|
Tobacco Use Disorder Substance-Related Disorders Mental Disorders |
ClinicalTrials.gov processed this record on June 17, 2013