Tobacco use is the leading preventable cause of both premature deaths overall and cancer deaths in the US. Most smokers visit a healthcare setting each year, providing an unequaled opportunity to intervene. Yet, most smokers do not receive highly effective cessation treatment during their healthcare visits.
To improve the effectiveness of smoking treatment in healthcare, this project will identify promising medication regimens and counseling strategies for use in primary care for the two most effective quit-smoking medications: varenicline (Chantix) and combinations of nicotine replacement therapy (C-NRT). To evaluate these treatments, the study will examine whether participants have quit after one year (biochemically confirmed) and how much it cost.
This project will recruit 608 participants from primary care clinics in two Wisconsin health systems, Aurora Health Care in the Milwaukee area and UW Health in the Madison, Wisconsin area. Those who want to quit smoking will be randomized to receive one of two levels of each of four factors:
1) Medication Type (Varenicline vs. C-NRT).
2) Preparation Medication (4 weeks vs. Standard).
3) Medication Duration (Extended [24 weeks] vs. Standard [12 weeks]).
4) Counseling Modality (In-Person vs. Phone).
The proposed research builds on UW-CTRI’s expertise and prior research findings to address how best to use the most effective quit-smoking medications in real-world healthcare settings. This research will use an efficient and innovative methodology (i.e., the Multiphase Optimization Strategy) to identify the most promising C-NRT and varenicline-based treatments to use with primary care patients who smoke. These optimized treatments will then be evaluated in a randomized clinical trial, BREATHE 2 Project 3: Optimization.