The US Department of Veterans Affairs has awarded a new grant to 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 UW-CTRI Researcher Dr. Jessica Cook, the project will offer 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,” Cook said, “by assisting those who need it most.”
The Enhanced Chronic Care system will provide 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 will work with UW-CTRI colleagues Elana Brubaker and Kirsten Webster to build on past success helping veterans quit by offering:
- Coaching and medications for veterans who are ready to quit smoking.
- Help to those unwilling to quit smoking via strategies to help them cut down on their smoking, with cessation treatment ready if they request it.
This “reduction treatment” has been shown to be effective in the UW-PASS Study. Reduction treatment is a notable addition to chronic care because it can get more smokers who are initially unwilling to quit into treatment that motivates them and encourages quit attempts. Cook views reduction treatment as an attainable first step in the path towards quitting that feels more approachable for some smokers.
Researchers will 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). Participants who are ready to quit will receive counseling and combination nicotine-replacement medications from the VA Tobacco Treatment Clinic. Those who choose reduction treatment will receive nicotine gum or nicotine lozenges, in addition to counseling. They’ll examine whether Enhanced Chronic Care helps participants quit long-term, whether it increases the use of tobacco interventions, and whether it’s feasible to implement at the VA.
“We hope this study will help us identify an effective smoking treatment strategy for VA clinical practice,” Cook said. “Helping more veterans quit smoking will improve the health of veterans across the VA.”