- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05997225
Tobacco Cessation at FDNY
Preventing Lung Cancer Through Tobacco Cessation at FDNY
Study Overview
Status
Conditions
Detailed Description
The overarching goal of this Randomized Controlled trial is to develop and test an effective, scalable intervention with potential to reach high-risk smokers undergoing CT lung cancer screening who have not engaged in or succeeded with traditional tobacco treatment approaches. The investigators will test an Enhanced Care intervention specifically designed to address multiple challenges to tobacco treatment engagement and success. First, the researchers will test opt-out enrollment in cessation treatment. The current tobacco treatment default, in which patients must opt-in to cessation treatment and are only offered counseling and pharmacotherapy when deemed ready to quit, results in missed opportunities to engage smokers into treatment. Previous studies of opt-out enrollment in cessation treatment suggest that an opt-out tobacco treatment strategy substantially increases engagement and cessation rates compared with traditional opt-in approaches. Second, proactive counseling will leverage the "reachable, teachable moment" of CT screening to motivate cessation through individually tailored messaging tied to CT results and lung function spirometry. Using CT results as a motivational tool has shown promise in pilot studies. The optimal approach and success of using CT coupled with spirometry results to motivate tobacco cessation remains unknown. Third, investigators will offer varenicline pre-loading to all enrollees, regardless of study arm, in which varenicline is initiated 4 weeks prior to target quit date. This approach is associated with decreased pre-quit tobacco-associated reward and double the rate of abstinence compared with standard varenicline treatment.
The investigators thus propose a randomized trial among retired FDNY World Trade Center Health Program responders participating in the FDNY World Trade Center Health Program CT screening program to test the effects of Enhanced Care (opt-out enrollment, tailored counseling based on CT and spirometry results, and varenicline with preloading) against Standard Care (opt-in enrollment, standard cessation counseling without CT tailoring, and varenicline with preloading) in the engagement of high-risk smokers in cessation treatment and the achievement of tobacco abstinence.
Study Type
Enrollment (Estimated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Shadi Nahvi, MD, MS
- Phone Number: 718 920 5379
- Email: shadi.nahvi@einsteinmed.edu
Study Contact Backup
- Name: David Goldfarb, PhD
- Phone Number: 718 403 4413
- Email: david.goldfarb@fdny.nyc.gov
Study Locations
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New York
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Brooklyn, New York, United States, 11201
- FDNY World Trade Center Health Program
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Contact:
- David Goldfarb, PhD
- Phone Number: 718-403-4413
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- self-reported current smoker as of participants' most recent FDNY World Trade Center Health Program questionnaire
- Enrolled in the FDNY World Trade Center Health Program Chest CT program
- Previously provided informed consent to World Trade Center Health Program Research
Exclusion Criteria:
- use of varenicline in past 30 days
- psychiatric instability (exacerbations in prior 3 months; current suicidal ideation or attempt, psych hospitalizations in past year)
- seizures
- pregnancy or breast feeding.
- alcohol use disorders
Study Plan
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: Enhanced Treatment
Opt-out counseling enrollment. individually-tailored biofeedback linked to Chest CT and spirometry results. Varenicline: Preloading regimen (prior to target quit date): 0.5 mg once a day for days 1-3, 0.5 mg twice a day for days 4-7, and 1 mg twice a day for days 8-28. 1 mg twice day for 12 weeks after target quit date. |
Participants automatically enrolled in motivational counseling.
Tailored counseling includes sharing results of Chest CT results and lung function spirometry tests with participants.
|
Active Comparator: Standard Treatment
Opt-in counseling enrollment. Standard tobacco cessation counseling. Varenicline: Preloading regimen (prior to target quit date): 0.5 mg once a day for days 1-3, 0.5 mg twice a day for days 4-7, and 1 mg twice a day for days 8-28. 1 mg twice day for 12 weeks after target quit date. |
Participants must opt-in to receive counseling.
Counseling does not include discussion of Chest CT or spirometry results.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Enrollment
Time Frame: 28 weeks
|
Enrollment is defined as first visit attendance with our tobacco treatment specialist in FDNY's Tobacco Cessation Program: Standard vs. Enhanced Care arms.
|
28 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Retention
Time Frame: 28 weeks
|
Number of participants retained to study end-date
|
28 weeks
|
Varenicline adherence
Time Frame: week 16
|
Assessed via electronic medication monitoring: pills taken / pills prescribed
|
week 16
|
Counseling adherence
Time Frame: week 28
|
Adherence with number of counseling visits attended as a continuous variable
|
week 28
|
Tobacco abstinence
Time Frame: end of treatment (16 weeks)
|
7-day point prevalence abstinence biochemically verified by urine cotinine < 30 ng/mL
|
end of treatment (16 weeks)
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Shadi Nahvi, MD, MS, Albert Einstein College Of Medicine
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2023-14980
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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