Changing the Default for Tobacco Treatment

Phase 4

Completed

Interventions: Behavioral: Opt In Treatment Program
Behavioral: Opt Out Treatment Program
Drug: Nicotine Replacement Therapy

Brief Summary: The purpose of this study is to determine the impact and efficacy of a new approach to smoking cessation treatment versus the traditional approach.

Detailed Description: In many health conditions, the default treatment approach is to first identify the health condition and then begin treatment. In this scenario, the physician discusses treatment options with the patient. The patient is free to decline treatment as they wish. If patients do nothing though, they will receive care.

For tobacco users, the default treatment is for them to "opt in" to receive smoking cessation assistance. The provider asks the smoker if they are ready to quit, and they offer medication and support only to those who respond back "yes". This limits the amount of smokers that receive treatment because only 1 in 3 smokers say they are ready to quit.

This study is looking at a novel approach to smoking cessation treatment. This study will compare the traditional, "standard of care" approach to opting in against a new approach where all smokers are provided with cessation medication and counseling unless they refuse it.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Opt Out	Nicotine Replacement Therapy	Participants in this arm will be first enrolled to receive cessation treatment and will only not receive it by "opting out". Participant will receive a Opt Out treatment program. Participants will receive counseling and nicotine replacement therapy.
Opt In	Opt In Treatment Program	Traditional approach to tobacco treatment program. Participants must first indicate they are ready to quit smoking by "opting in" to receive Opt In treatment program.
Opt Out	Opt Out Treatment Program	Participants in this arm will be first enrolled to receive cessation treatment and will only not receive it by "opting out". Participant will receive a Opt Out treatment program. Participants will receive counseling and nicotine replacement therapy.
Opt In	Nicotine Replacement Therapy	Traditional approach to tobacco treatment program. Participants must first indicate they are ready to quit smoking by "opting in" to receive Opt In treatment program.

Primary Outcome Measures

Name	Time	Method
7-day Point-prevalence Abstinence	Month 1	7-day, self-reported and verified cigarette abstinence.

Secondary Outcome Measures

Name	Time	Method
Treatment Engagement	Month 1	Percentages of participants who use cessation medications and participate in counseling post discharge
7-day Point-prevalence Abstinence	Month 6	7-day, self-reported and verified cigarette abstinence.
Default-theory Based Measures	Month 1	We will assess the impact of opt-out versus opt-in treatment on perceived treatment coercion using items adapted from the Admission Experience Survey (AES) short form.