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Evaluating an Innovative Tobacco Treatment Approach for Veterans in Substance Use Treatment (Co-STOP)

2026年9月9日 更新者:VA Office of Research and Development

Evaluating an Innovative Tobacco Treatment Approach for Veterans in Substance Use Disorder Treatment

Veterans with substance use disorders smoke at extraordinarily high rates and have high rates of smoking-related death and disease. It is essential to provide tobacco treatment for Veterans with substance use disorders, but there are unfortunately low rates of smoking treatment engagement within the VA for those with substance use disorders. The goal of this project is to generate preliminary evidence for a smoking intervention program called "Concurrent Substance and Tobacco Outpatient Program" or Co-STOP. Co-STOP aims to increase tobacco treatment use and effectiveness for Veterans in outpatient substance use treatment. The investigators hypothesize that Co-STOP, relative to standard tobacco treatment, will increase tobacco treatment use and quit attempts. This research will help the VA develop effective strategies to promote smoking treatment use and abstinence in Veterans with substance use disorders who smoke, thereby improving rates of morbidity and mortality in Veterans with substance use disorders.

調査の概要

詳細な説明

This project will generate knowledge about strategies to increase smoking treatment engagement in Veterans with substance use disorders, a group that suffers disproportionately from smoking-related disease and death. This project will This project will evaluate the acceptability, feasibility, and preliminary efficacy of the Co-STOP program relative to standard cessation treatment offered at the VA. Co-STOP is an intervention designed to make tobacco treatment part of routine care for Veterans in substance use treatment and thereby enhance tobacco treatment use and quit attempts. Co-STOP offers evidence-based counseling and nicotine replacement therapy for smoking cessation as well as smoking reduction or changes if Veterans are not willing to quit. In Co-STOP, treatment is provided unless the Veteran declines, and makes tobacco treatment the default during substance use treatment. It is expected that Enhanced Chronic Care will increase treatment use and smoking abstinence relative to Standard Care.

This project will randomize N=112 Veterans receiving VA outpatient SUD care who smoke daily in a 1:1 ratio to Co-STOP or SC in a pilot randomized controlled trial (RCT). Co-STOP participants will be informed that they will be provided with evidence-based smoking treatment, which does not require a commitment to quit, as part of their SUD care, unless they opt-out. Co-STOP participants who do not opt out will receive 4 months of nicotine replacement therapy (NRT) and five behavioral counseling calls to support making 'healthy changes' or quitting smoking. SC participants will be offered entry into standard VA cessation treatment. Outcomes will be assessed over 4-months post-study entry. The investigators hypothesize that relative to SC, Co-STOP will increase smoking treatment use (i.e., use of NRT + counseling) and the likelihood of making a quit attempt.

研究の種類

介入

入学 (推定)

112

段階

  • フェーズ 4

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • Wisconsin
      • Madison、Wisconsin、アメリカ、53705-2254
        • William S. Middleton Memorial Veterans Hospital, Madison, WI
        • コンタクト:
        • 主任研究者:
          • Jennifer M. Betts, PhD

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Smoke at least one cigarette per day
  • Be engaged in VA outpatient substance use treatment for at least one month
  • Be medically eligible to use Nicotine Replacement Therapy (NRT)
  • Not currently receiving smoking treatment
  • Not currently at high risk for suicide
  • Have an email address

Exclusion Criteria:

  • Unable to give informed, voluntary consent to participate
  • Incarceration

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:Co-STOP
Co-STOP participants will receive evidence-based smoking treatment, that does not require a commitment to quit, as routine part of their SUD care unless they decline treatment. This will include 4 months of counseling and NRT to support the smoking change goal on which they would like to work. All participants in the Co-STOP condition will receive Healthy Changes treatment, which focuses on making manageable changes to smoking, unless they choose to make a quit attempt (or decline treatment). If they choose to make a quit attempt, they will receive Cessation Treatment.
All participants in Co-STOP will receive their choice of nicotine mini-lozenge or gum for 4 months, unless they decline or start Cessation Treatment instead. If <30 min to first cigarette of the day then 4mg mini-lozenges/gum will be prescribed, and if ≥30 min to first cigarette of the day then 2-mg mini-lozenges/gum will be prescribed. Participants will be encouraged to use NRT in place of smoking (5-15 pieces/day).
他の名前:
  • ニコレット
If a participant enters Cessation Treatment, they will receive combination NRT (patch with participant choice of mini-lozenge or gum). Nicotine patch dosing, which will begin on the TQD, will be will be consistent with medication labeling; i.e., if smoking >10 cigarettes/day= starting at 21-mg; if smoking ≤10 cigarettes/day = starting at 14-mg nicotine patches. Similarly, dosing for nicotine mini-lozenge/gum: <30 min to 1st cig/day starting at 4mg every 1-2 hours; if ≥30 min to 1st cig/day, then starting at 2mg every 1-2 hours.
他の名前:
  • Nicorette, NicoDerm
All participants who enter cessation treatment will receive five, 15-20 minute counseling calls over 16 weeks. Calls will be scheduled at approximately 1-week pre-target quit day (TQD), 1-day post TQD, and three flexible sessions up to week 16. Prior to quitting, the study counselor will reinforce reasons for quitting, discuss past quit experiences, and develop a quit day plan. Post-quit sessions will include coping with cravings, identifying high-risk situations (e.g., co-use with other substances), developing behavioral plans for high-risk situations, and a plan to manage a lapse/relapse.
All participants in Co-STOP will receive counseling calls for Healthy Changes Counseling unless they choose to enter Cessation Treatment or decline. Participants will receive five, 15-20 minute counseling phone calls over 16 weeks. During counseling calls, the study counselor will work with participants to develop smoking change goals, including smoking reduction, changing smoking contexts, and using NRT. Counseling sessions will explore participants' motivations for changing their tobacco use and address pragmatic issues such as co-use with other substances, work contexts, smoking policies, and habits that interfere with desired changes. Counseling will emphasize competence and self-efficacy, both of which will be linked to the practice of smoking change skills.
アクティブコンパレータ:Standard Care
Participants in Standard Care will be asked if they are interested in quitting smoking in the next month, and if so, they will be offered Cessation Treatment, which is consistent with existing VA standard care.
If a participant enters Cessation Treatment, they will receive combination NRT (patch with participant choice of mini-lozenge or gum). Nicotine patch dosing, which will begin on the TQD, will be will be consistent with medication labeling; i.e., if smoking >10 cigarettes/day= starting at 21-mg; if smoking ≤10 cigarettes/day = starting at 14-mg nicotine patches. Similarly, dosing for nicotine mini-lozenge/gum: <30 min to 1st cig/day starting at 4mg every 1-2 hours; if ≥30 min to 1st cig/day, then starting at 2mg every 1-2 hours.
他の名前:
  • Nicorette, NicoDerm
All participants who enter cessation treatment will receive five, 15-20 minute counseling calls over 16 weeks. Calls will be scheduled at approximately 1-week pre-target quit day (TQD), 1-day post TQD, and three flexible sessions up to week 16. Prior to quitting, the study counselor will reinforce reasons for quitting, discuss past quit experiences, and develop a quit day plan. Post-quit sessions will include coping with cravings, identifying high-risk situations (e.g., co-use with other substances), developing behavioral plans for high-risk situations, and a plan to manage a lapse/relapse.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Treatment Engagement
時間枠:At the end of 4 month treatment
Rates of self-reported use of nicotine replacement therapy and attending at least one counseling session
At the end of 4 month treatment

二次結果の測定

結果測定
メジャーの説明
時間枠
24h Quit Attempt
時間枠:At the end of 4 month treatment
Rates of self-reported quit attempt lasting at least 24 hours during the study
At the end of 4 month treatment

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Jennifer M. Betts, PhD、William S. Middleton Memorial Veterans Hospital, Madison, WI

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2027年4月1日

一次修了 (推定)

2030年4月1日

研究の完了 (推定)

2031年9月30日

試験登録日

最初に提出

2026年9月3日

QC基準を満たした最初の提出物

2026年9月3日

最初の投稿 (実際)

2026年9月9日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月14日

QC基準を満たした最後の更新が送信されました

2026年9月9日

最終確認日

2026年9月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

Deidentified dataset will be shared upon request.

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米国FDA規制機器製品の研究

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米国で製造され、米国から輸出された製品。

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