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Tobacco Cessation Interventions for Mental Health Patients

Institution: Veterans Medical Research Foundation
Investigator(s): Mark Myers, Ph.D.
Award Cycle: 2011 (Cycle 20) Grant #: 20XT-0141 Award: $353,356
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Exploratory/Developmental Award
Abstracts

Initial Award Abstract
Research consistently indicates that individuals with mental health disorders smoke cigarettes at rates substantially higher than those of the general population. These high smoking rates have been a source of concern and attention for some time. However, limited research has addressed this issue and few evidence-based treatments are currently available for this high risk population.

This pilot study compares the effectiveness of two different smoking cessation intervention programs for military veteran cigarette smokers with current psychiatric disorders. Participants will be randomly assigned to one of two existing tobacco cessation clinics within the Veterans Affairs San Diego Healthcare System (VASDHS): a specialty tobacco cessation clinic for mental health patients and a pharmacist managed telephone counseling clinic (PMTTCC). The key goal of the proposed study is to evaluate whether a specialty cessation clinic for smokers with psychiatric illness that provides long-term ongoing intervention and support results in higher rates of quitting compared with telephone counseling. One hundred and twenty military veteran smokers with a psychiatric illness will be assigned to either the VASDHS Mental Health Tobacco Cessation Clinic or the VASDHS PMTTCC. All participants will receive nicotine patch in combination with nicotine gum or nicotine lozenge, and be followed for 6-months following their quit date. Participants will be assessed four times (prior to treatment, and 1-, 3-, and 6-months following their quit date) to provide initial effectiveness data.

The first aim of the project is to compare smoking cessation outcomes for the Mental Health Tobacco Cessation Clinic and the Pharmacy Managed Telephone Tobacco Cessation Clinic with psychiatric patients. This will be accomplished by comparing rates of abstinence from smoking, quit attempts, and reductions in cigarette use across the treatment conditions. The second aim of the project is to compare treatment adherence for the Mental Health Tobacco Cessation Clinic and the Pharmacy Managed Telephone Tobacco Cessation Clinic with psychiatric patients. This will be accomplished by comparing how many sessions are attended and how much of the prescribed medication is used by participants in each treatment conditions Additional aims are to explore whether successful quitting differs by type of psychiatric illness and to explore effects of quitting smoking on psychiatric symptoms.

The proposed study is designed to provide pilot data for a large scale randomized controlled effectiveness study. The ultimate goal of this line of research is to develop, test and implement behavioral and pharmacological interventions for cigarette smokers with psychiatric illness.
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