UW-CTRI has 10 active studies. These include:
- COVID EHR Cohort at the University of Wisconsin (CEC-UW). UW-CTRI has joined the quest to better understand COVID-19. The National Cancer Institute has asked UW-CTRI researchers to reach out to health systems associated with the Cancer Center Cessation Initiative (C3I), coordinated at UW. The goal is to explore whether patient demographic and other electronic health record (EHR) variables —including smoking status and cancer —in patients diagnosed with COVID-19 are associated with disease severity, complications and/or mortality. The CEC-UW initiative is led by Principal Investigator Dr. Michael Fiore and includes other UW-CTRI and C3I Coordinating Center staff including Rob Adsit, Karen Conner, Stevens Smith, Betsy Rolland, Julie Kirsch, Todd Hayes-Birchler, Kari Giacolone, Douglas Jorenby, Wendy Theobald, Brian Williams, Jonah Stankovsky, and Lisa Rogers. Tim Baker is serving as Senior Scientist on the CEC-UW project. Twenty-one health systems across the nation are participating in the project, most of which are also C3I sites. Data collection for the project concluded at the end of January 2022. EHR data on approximately 1.5 million patients who tested positive for, or were diagnosed with, COVID-19 was collected, including 149,989 hospitalized patients. May 2020-September 2022, $3 million. Funded by NCI. Dr. Michael Fiore, PI.
- Predicting Patient Outcomes in Wisconsin and Nationwide Using the University of Wisconsin’s COVID-19 EHR Cohort Database. The major goal of this study is to utilize the COVID EHR Cohort at the University of Wisconsin (CEC-UW) database to improve the health and well-being of the people of Wisconsin. This will be accomplished by examining predictors of patient outcomes at the UW Health site specifically and conducting focused contrasts of effects found at UW Health to those at other participating health systems. February 2022-January 2024, $300,000. Funded by Wisconsin Partnership Program. Michael Fiore and Tom Piasecki, PIs.
- Breaking Addiction to Tobacco for Health 2 (BREATHE 2). In a first, researchers at the University of Wisconsin are comparing the most effective treatments to help people quit smoking in real-world clinics, with a goal of tailoring and optimizing help to people who smoke. Under the direction of Drs. Timothy Baker and Michael Fiore, UW-CTRI is partnering with health systems to treat more than 4,000 clinic patients. They’re reaching out to patients listed as people who smoke in electronic health records to help those who are ready to quit and motivate those who aren’t. The innovative experiment will be the first to experimentally compare the two most effective interventions available—varenicline (Chantix) vs. combination nicotine-replacement medications—and determine whether they are enhanced by type of counseling (in-person vs. phone), or by extra medication before quitting or after the standard treatment. About 25 million people who smoke in America make a primary care visit each year, but only about five percent of people who smoke who try to quit use the cessation counseling and medication we know can help. In this study, the research team will reach out to them and offer these treatments. May 2019-May 2024, $12.5 million. Funded by NCI. Drs. Timothy Baker and Michael Fiore, PIs.
- VA Merit Grant. US Department of Veterans Affairs awarded a grant to UW-CTRI Researcher Dr. Jessica Cook and the William S. Middleton Memorial Veterans Hospital (VA) in Madison to be the first ever to evaluate a chronic care system designed to help Veterans who are both ready and not ready to quit smoking. Many Veterans become addicted to tobacco during their military service. Led by Cook, the team is implementing the grant at the VA, offering telemedicine visits for all Veterans who smoke, including rural Veterans who cannot afford to drive into Madison for visits. It’s a way of giving back to Veterans who have sacrificed so much for our country by assisting those who need it most. The Enhanced Chronic Care system provides ongoing motivational interventions and interpersonal support to Veterans who use tobacco but are not ready to quit. The treatment is designed to encourage Veterans to use evidence-based tobacco treatment and to ultimately help them quit. Cook works with UW-CTRI colleagues Elana Brubaker and Kirsten Webster to recruit 250 Veterans who smoke to receive the Enhanced Chronic Care intervention, and another 250 to receive the Standard Care (brief advice to quit once per year). The researchers hope this study will help identify an effective smoking treatment strategy for VA clinical practice. January 2019-December 2023, $1 million. Funded by the VA. Dr. Jess Cook, PI.
- Motivating Change in Aging People Who Smoke. This K23 award funds a research study to increase smoking cessation in adults age 50 and older. While these adults smoke at lower rates (8.2%) than the general population (13%), their cessation rates are also lower because they are less likely to be advised to quit or offered help by providers. A common misperception is that mature adults can’t or won’t quit and, if they do, they won’t benefit from it. But the research reflects the contrary. When they do try to quit, they’re generally more successful than younger people, especially when they use evidenced-based treatments (which double their success). The study will run qualitative interviews to look at what might motivate older adults to quit. One potential incentive is pointing out that quitting smoking can reduce risk for cognitive decline—commonly cited as the greatest fear among mature adults, but one yet to be used for motivation with smoking cessation. UW-CTRI will recruit participants via signs, posters, calls from each person’s clinic, and a letter to motivate and offer treatment. Researchers will compare that to a clinic with no message and a clinic with a standard motivational method. The group plans to run the study at three clinics in the same health system. They’ll be tuned into any behavioral health symptoms and the socioeconomic status of the participants to better analyze and interpret results. Drs. Megan Piper, Carey Gleason, Jane Mahoney, and Jessica Cook are serving as co-mentors to Principal Investigator Dr. Adrienne Johnson. May 2021-Feb 2026, $782,000. Funded by the National Institute on Aging of the National Institutes of Health. Dr. Adrienne Johnson, PI.
- Alzheimer’s Disease Research Center (ADRC) Developmental Grant. This project aims to develop a tailored intervention for African Americans age 50 and older to motivate them to quit smoking. African Americans are disproportionately more likely than white adults to develop dementia and suffer health effects of smoking. For this project, UW-CTRI Researcher Dr. Adrienne Johnson is collaborating with Lorraine Lathen, Director of the Wisconsin African American Tobacco Prevention Network. April 2021-March 2023, $150,000. Funded by the Wisconsin Alzheimer’s Disease Research Center with funds from the National Institute on Aging of the National Institutes of Health. Adrienne Johnson, PI.
- Withdraw from Tobacco Study. This study has recruited more than 200 people to quit without medication for the first week. All participants then get eight weeks of combination nicotine-replacement medication (nicotine patch and mini lozenge). Study staff provide coaching to help participants quit smoking and confirm their smoking status 9 weeks after the quit date. One of the important products of our research at UW-CTRI is the Wisconsin Smoking Withdrawal Scale (WSWS). The Withdraw from Tobacco Study, led by Dr. Tim Baker and Dr. Jesse Kaye, will be critical to improving the scale, making it congruent with recent research on the nature of smoking withdrawal. June 2021-December 2022, $1.2 Million. Funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health. Drs. Timothy Baker and Jesse Kaye, PIs.
- First Breath Families: Helping Low-Income Moms Quit Smoking and Babies Grow Up Smoke-Free. The Wisconsin Women’s Health Foundation (WWHF) has received a $1 million grant from the Wisconsin Partnership Program to significantly expand efforts to bring quit-smoking services to high-risk individuals, families and communities across Wisconsin. UW-CTRI is collaborating with WWHF on this project, to be provided during five years to First Breath Families. The group will also seek systems changes that will provide sustainable funding for these services. The First Breath Families team will collaborate with local agencies that serve pregnant and postpartum women and their families, provide statewide access to local WWHF Quit Coaches, and develop participant-informed services. January 2018-December 2022, $1,000,000. Funded by the Wisconsin Partnership Program/Oversight & Advisory Committee (WPP/OAC). Karen Conner and Dr. Michael Fiore, Academic Partners. Lisette Kahlil, Wisconsin Women’s Health Foundation Community Lead.
- Improving Quitline Support Study (IQS). This project evaluated promising strategies to enhance quit-smoking success among low-income people who smoke. Researchers enrolled 1,408 Medicaid-eligible or uninsured people who smoke who continued smoking four months after engaging in standard services from the Wisconsin Tobacco Quit Line. These people who smoke were invited to participate in an experiment to evaluate the value of augmenting standard Quit Line treatment with more intensive counseling, more intensive nicotine replacement, NCI’s SmokefreeTXT text support program, and/or financial incentives for using Quit Line and SmokefreeTXT support. Analyses will examine the main and interactive effects of these four treatment components at 26 weeks, as well as other quit-smoking outcomes in this at-risk population. August 2017-July 2022, $3 million. Funded by the National Cancer Institute of the National Institutes of Health. Drs. Danielle McCarthy and Michael Fiore, PIs.
- Cardiac and LUng E-cigarette smoking Study (CLUES). The UW Atherosclerosis Imaging Research Program (UW AIRP) and UW-CTRI are collaborating on a study on the acute and chronic effects of vaping and dual use of cigarettes and e-cigarettes. UW-CTRI is collaborating on the project. The project is led by UW AIRP Director and Cardiologist Dr. James Stein and UW-CTRI Director of Research Dr. Tim Baker. The study is enrolling 440 participants representing four groups: people who vape, smoke, vape and smoke, or never used. Participants receive $200 for two study visits. The study uses an array of tests to explore relations between:
- Acute smoking and/or vaping with possible cardiovascular and pulmonary disease mechanisms.
- Longer-term patterns of smoking and/or vaping with measures of cardiovascular and pulmonary dysfunction and injury.
These outcome biomarkers will predict future disease risk and measure injury to arteries and lungs. For cardiovascular disease (CVD), the primary biomarkers are brachial artery flow-mediated dilation (FMD, a measure of endothelial function that predicts CVD) and carotid intima-media thickness (IMT, a measure of subclinical arterial injury and atherosclerosis that also predicts CVD events). For pulmonary disease, the primary biomarkers are predicted lung volumes and flow rates obtained by spirometry. In secondary analyses, researchers will:
- Characterize carotid artery echogenicity (a novel measure of arterial injury).
- Perform treadmill exercise stress testing (to measure exercise capacity, heart rate recovery, heart rate reserve, and rate-pressure product).
- Electrocardiography (to measure heart rate variability).
- Measure blood pressure, fasting lipids, HbA1c, markers of inflammation and oxidation (leukocyte count, C-reactive protein, F2 isoprostanes), and exhaled nitric oxide. These tests index the degree of dysfunction, injury mechanisms, and future risks of cardiovascular and pulmonary disease.
UW-AIRP Manager Dr. Claudia Korcarz coordinates the study and UW-CTRI Director of Clinical Services Dr. Doug Jorenby serves as the on-site and operational scientific lead. Dr. Nathan Sando is overseeing all pulmonary measurements. UW-AIRP Research Specialist Kristin Hansen will assist with tests. Holly Prince of UW-CTRI is managing study visits in Madison. September 2018-August 2022, $1.8 million. Funded by NIH. Drs. Timothy Baker and James Stein, PIs.