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Research consistently indicates that individuals with psychiatric disorders smoke cigarettes at substantially higher rates than the general population. Consequently, tobacco-related morbidity and mortality are disproportionately higher for this group leading to a tobacco-related health disparity for this population. Although motivations to quit, interest in cessation treatment, and efforts to quit among smokers with psychiatric disorders mirror the general population of smokers, they have significantly greater difficulty achieving long term abstinence. Existing research indicates that smoking cessation treatment approaches found effective for the general population are also effective for smokers with psychiatric disorders. Thus, putting smokers in contact with structured treatments may be especially important for those with psychiatric disorders.
This Exploratory/Developmental Award aims to develop and evaluate the efficacy of a brief intervention delivered by telephone to facilitate participation in outpatient tobacco cessation treatment (TTE). Participants will be military veteran cigarette smokers with psychiatric disorders referred for tobacco cessation treatment within the Veterans Affairs San Diego Healthcare System. TTE will be compared to routine practice (SCT), consisting of a brief telephone contact informing the veteran of available programs and how to access them
The proposed study has a number of objectives. The first aim of the project is to develop and refine a telephone-delivered brief treatment engagement intervention.
The second aim of the project is to compare treatment engagement during the month following intervention across the two study conditions.
The first phase of the study consists of developing the intervention based on input from focus groups of veterans with psychiatric disorders who smoke in order to learn about their views regarding obstacles to and benefits of taking part in tobacco cessation treatment. Once the initial treatment has been developed, it will be administered to pilot participants who will then take part in interviews to provide feedback regarding their perceptions and experience of the intervention. This process will result in the final treatment to be evaluated.
The second phase of the study is a pilot efficacy trial, in which 105 military veteran smokers with psychiatric disorders will be randomly assigned to receive either the TTE or SCT telephone conditions. All participants will be assessed over 3 months following the intervention to evaluate whether taking part in smoking cessation treatment differs by intervention condition. The primary outcome will be whether participants take part in an evidence-based treatment for tobacco cessation during the 30 days following the telephone contact.
The proposed study is designed to provide pilot data for a large scale randomized controlled efficacy trial. The ultimate goal of this line of research is to develop and test approaches targeting high-risk smokers at significantly elevated risk for difficulties quitting with the goal of increasing engagement in empirically supported smoking cessation interventions.
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