Financial Incentives for Smoking Treatment

Not Applicable

Completed

• Conditions: Smoking; Smoking, Tobacco; Tobacco Use Disorder
• Interventions: Behavioral: Smoking cessation counseling (Quitline); Behavioral: Smoking cessation pharmacotherapy (e.g, nicotine replacement therapy); Behavioral: Financial incentives

• Registration Number: NCT02506829
• Lead Sponsor: NYU Langone Health

Brief Summary

The investigators plan to compare the impact of two approaches for smoking cessation on smoking abstinence, use of evidenced-based therapy, and quality of life among a diverse population of patients at the Manhattan campus of the VA New York Harbor Healthcare System, which serves a critical safety-net role for urban veterans. During hospitalization, all smokers will receive usual care. Patients will be randomized to one of two arms: financial incentives plus usual care vs. usual care alone, which includes referral to the state Quitline. All patients enrolled in the study will be offered nicotine replacement therapy. The investigators will conduct follow-up assessments at 2 weeks, 2 months, 6 months and 12 months after discharge. The primary study outcome is smoking abstinence at 6-month follow-up, verified by salivary/urinary cotinine.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2015-07
• Study First Submitted: 2015-07-01
• Study First Submitted QC: 2015-07-22
• Study First Posted: 2015-07-23
• Primary Completion: 2019-03-05
• Study Completion: 2019-05-20
• Status Verified: 2020-12
• Last Update Submitted: 2020-12-09
• Last Update Posted: 2020-12-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 182

Inclusion Criteria

1. age ≥ 18 years,
2. smoked tobacco during the prior 30 days,
3. have an active U.S. phone number and address,
4. can provide consent in English and
5. are in at least the contemplative stage of change for quitting smoking, as assessed by a single measure, readiness to quit

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Exclusion Criteria

1. use only smokeless tobacco,
2. are pregnant or breastfeeding,
3. are discharged to an institution (e.g., nursing home, long-term care facility),
4. are unable to provide informed consent, or do not have cognitive ability to enroll or participate in the study

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Usual care	Smoking cessation pharmacotherapy (e.g, nicotine replacement therapy)	Usual care in hospital, referral to a smoking cessation Quitline on discharge from hospital.
Financial Incentives	Financial incentives	Usual care in hospital, referral to a smoking cessation Quitline on discharge from hospital. Financial incentives for: a) speaking with a coach from the Smoker's Quitline ($50), b) completion of another community-based smoking-cessation program ($50), and/or c) use of pharmacotherapies for smoking cessation at 2 weeks ($50); and d) for smoking cessation, confirmed with the use of a cotinine test at 2 months ($150); and e) for smoking cessation, confirmed with the use of a cotinine test at 6 months after study enrollment ($250).
Financial Incentives	Smoking cessation counseling (Quitline)	Usual care in hospital, referral to a smoking cessation Quitline on discharge from hospital. Financial incentives for: a) speaking with a coach from the Smoker's Quitline ($50), b) completion of another community-based smoking-cessation program ($50), and/or c) use of pharmacotherapies for smoking cessation at 2 weeks ($50); and d) for smoking cessation, confirmed with the use of a cotinine test at 2 months ($150); and e) for smoking cessation, confirmed with the use of a cotinine test at 6 months after study enrollment ($250).
Usual care	Smoking cessation counseling (Quitline)	Usual care in hospital, referral to a smoking cessation Quitline on discharge from hospital.
Financial Incentives	Smoking cessation pharmacotherapy (e.g, nicotine replacement therapy)	Usual care in hospital, referral to a smoking cessation Quitline on discharge from hospital. Financial incentives for: a) speaking with a coach from the Smoker's Quitline ($50), b) completion of another community-based smoking-cessation program ($50), and/or c) use of pharmacotherapies for smoking cessation at 2 weeks ($50); and d) for smoking cessation, confirmed with the use of a cotinine test at 2 months ($150); and e) for smoking cessation, confirmed with the use of a cotinine test at 6 months after study enrollment ($250).

Primary Outcome Measures

Name	Time	Method
Smoking abstinence assessed by self-reported and biochemically verified by salivary cotinine	6 months	Assessed by self-report questionnaire, and biochemically verified by salivary cotinine

Secondary Outcome Measures

Name	Time	Method
Long term return on investment of using financial incentives to promote smoking cessation (Cost analysis)	3 years	Cost analysis involving hospital utilization data, electronic health records and patient-reported healthcare utilization
Smoking abstinence assessed by self-report	6 months	Assessed by self-report questionnaire
Short term return on investment of using financial incentives to promote smoking cessation (Cost analysis)	12 months	Cost analysis involving hospital utilization data, electronic health records and patient-reported healthcare utilization
Use of evidence based treatment (e.g. counseling and smoking cessation medications) assessed by discharge prescriptions, Quitline records, receipts, letters and/or self-report	2 weeks and 2 months	Assessed by discharge prescriptions, Quitline records, receipts, letters and/or self-report
Quality of life as measured by the EQ5-D and VR-12	6 months	As measured by the EQ5-D and VR-12

Trial Locations

Locations (1)

New York University School of Medicine; 🇺🇸 New York, New York, United States