Developing a Smoking Cessation Intervention for Methadone Maintained Smokers

September 4, 2018 updated by: Nina A. Copperman, Psy. D., Rutgers, The State University of New Jersey

The purpose of this study is to pilot and evaluate, in a randomized controlled trial, the immediate and long-term effects of a newly developed, tailored, intensive smoking cessation intervention among methadone maintained smokers and compared to a control condition (facilitated referral to the NJ Quitline). The newly developed intervention is evidence based, addresses the unique needs of methadone maintained smokers, is intensive, can be tailored to the individual, and builds on the strengths as well as addresses the gaps in previous treatments for methadone maintained smokers.

The investigators hypothesize that: (1) three months and six months after beginning treatment, those in the tailored intervention condition will be more likely to be abstinent from smoking than those in the control intervention condition (primary outcome); (2) there will be a greater relapse rate in the control intervention condition between the three and six month follow-up points than in the tailored intervention condition; (3) three and six months after beginning treatment, those in the tailored intervention condition will have better secondary smoking related outcomes (smoked fewer cigarettes per day in the past week, be more ready to quit, have greater self-efficacy for quitting, experience less nicotine dependence, and be more likely to have made a quit attempt) than those in the control intervention condition; (4) three and six months after beginning treatment, those in the tailored intervention condition will have better utilization of and adherence to smoking cessation pharmacotherapy, better mental and physical health, less perceived stress, greater social support, less drug and alcohol use, and greater involvement in drug and alcohol treatment than those in the control intervention condition; and (5) the newly created tailored intervention will be feasible and acceptable. .

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Most individuals in methadone maintenance treatment are tobacco smokers. Also, people in methadone treatment are more likely to experience the health issues related to smoking than the general population. Yet, research has found that smokers receiving methadone treatment are interested in quitting and receiving tobacco cessation treatment, and people in drug treatment who quit smoking are less likely to use drugs.

To better help methadone maintained smokers quit smoking and prevent them from starting smoking again, we want to evaluate the effects of a new smoking cessation counseling intervention, designed for methadone maintained smokers as compared to a smoking cessation counseling intervention used with the general population.

Eligible participants will:

  • Be English speaking (i.e., able to participate in counseling sessions in English and to complete study interviews in English);
  • Be enrolled in methadone treatment for at least three months;
  • Be able to give informed consent;
  • Be willing and able to participate in all study activities;
  • Not have taken smoking cessation related medication or participated in smoking cessation counseling in the past six months;
  • Have smoked at least 100 cigarettes during their lifetime and currently smoke every day or most days;
  • Not currently be pregnant or breastfeeding or plan on getting pregnant or breastfeeding during the next six months;
  • Have access to a working telephone; and,
  • Be interested in participating in a smoking cessation intervention and quitting smoking within the next six months.

Participants will be randomly assigned to receive either a smoking cessation intervention tailored for methadone maintained smokers or a referral to a smoking cessation program available to the general population (NJ Quitline). Participants assigned to receive the tailored intervention, will participate in approximately eight individual counseling sessions, with a smoking cessation counselor, over three months. Each session will last approximately 45 minutes and occur in the participant's methadone clinic. Treatment needs will be assessed during the first session and the intervention will be tailored to participants' needs. Prior to quitting participants will receive nicotine replacement patches and lozenges and instructions on how to use them.

Study staff will contact the NJ Quitline for participants assigned to the control condition, and a counselor from the Quitline will call them.

Regardless of treatment assignment, participants will be asked to provide a urine sample for a drug test and pregnancy test (for women) and complete an interview, using a computer or face-to-face, before beginning treatment or receiving the NJ Quitline referral and three months and six months after study enrollment.Each interview will take approximately 45 minutes to one hour to complete.

Participants will receive a $20 gift card for completing each research visit (i.e., computer or face-to-face interview), but will not be reimbursed for counseling visits.

Study Type

Interventional

Enrollment (Actual)

87

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New Jersey
      • New Brunswick, New Jersey, United States, 08901
        • Rutgers Robert Wood Johnson Medical School

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Enrolled in methadone treatment for at least three months
  • Able to give informed consent
  • Willing and able to participate in all study activities
  • Smoked at least 100 cigarettes during their lifetime
  • Currently smoke every day or most days
  • Has access to a working telephone
  • Interested in participating in a smoking cessation intervention and quitting smoking within the next six months

Exclusion Criteria:

  • Unable to speak English fluently
  • Took smoking cessation related medication or participated in smoking cessation counseling in the past three months
  • Pregnant or breastfeeding or planning on becoming pregnant or breastfeeding during the next six months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intensive, tailored intervention
Participants in the intensive intervention condition will receive eight individual counseling sessions, with a smoking cessation counselor, over three months. Each session will last approximately 45 minutes and occur in the methadone clinic. Participant treatment needs will be assessed during the first session and the intervention will be tailored to the participants' needs. Prior to quitting participants will receive nicotine replacement patches and lozenges and instructions on how to use them.
Behavioral: Intensive, tailored intervention
Eight, 45 minute counseling sessions, tailored to the individual and based on the Information-Motivation-Behavioral Skills model of behavior change. Incorporates motivational interviewing, education, cognitive-behavioral skills training. 12 week course of nicotine replacement patches provided. Nicotine lozenges also provided.
Other Names:
  • Smokers in Methadone Treatment Intervention
  • IMB Model Based Smoking Cessation Intervention
Active Comparator: Control Intervention
Participants randomized to the control intervention will receive a referral to the NJ Quitline (a telephone smoking cessation counseling service). Participants will receive a brochure and information about the referral. Study staff will contact the NJ Quitline for control participants, and a counselor from the Quitline will call control participants.
Behavioral: NJ Quitline Referral
Participants will receive a facilitated referral to the NJ Quitline (i.e. fax to quit).
Other Names:
  • Standard of Care Smoking Cessation Intervention
  • General Population Smoking Cessation Intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants Who Experienced Seven-day Point Prevalence Smoking Abstinence
Time Frame: during the previous seven days at three months post baseline
Self-reported not smoking "even a puff" within the previous seven days, and exhaled carbon monoxide reading of <8 parts per million.
during the previous seven days at three months post baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Median Number of Cigarettes Participants Smoked Per Day During the Past Week
Time Frame: during the previous seven days at three months post baseline
Self-reported, median number of cigarettes per day during the previous seven days
during the previous seven days at three months post baseline
Number of Participants Who Experienced Any Quit Attempts Since Baseline
Time Frame: During the period between baseline and three months post enrollment
Self-reported, smoke free for 24 hours or more since baseline (yes/no)
During the period between baseline and three months post enrollment
Number of Participants Who Experienced Seven-day Point Prevalence of Smoking Abstinence
Time Frame: during the previous seven days at six months post baseline
Self-reported not smoking "even a puff" within the previous seven days, and exhaled carbon monoxide reading of <8 parts per million.
during the previous seven days at six months post baseline
Median Number of Cigarettes Smoked Per Day During the Past Week
Time Frame: during the previous seven days at six months post baseline
Self-reported, median number of cigarettes per day during the previous seven days
during the previous seven days at six months post baseline
Number of Participants Who Experienced Any Quit Attempts Since Enrollment
Time Frame: during the period between baseline and six months post-enrollment
Self-reported, smoke free for 24 hours or more since baseline (yes/no)
during the period between baseline and six months post-enrollment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rutgers, The State University of New Jersey

Collaborators

National Institute on Drug Abuse (NIDA)

Investigators

  • Principal Investigator: Nina Cooperman, Psy.D., Rutgers Robert Wood Johnson Medical School

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2011

Primary Completion (Actual)

May 1, 2014

Study Completion (Actual)

May 1, 2014

Study Registration Dates

First Submitted

June 27, 2011

First Submitted That Met QC Criteria

July 11, 2011

First Posted (Estimate)

July 13, 2011

Study Record Updates

Last Update Posted (Actual)

September 6, 2018

Last Update Submitted That Met QC Criteria

September 4, 2018

Last Verified

September 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • K23DA025049 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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