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Smoking CessationPhase 4NCT02995915

Mobile Contingency Management for Concurrent Abstinence From Alcohol and Smoking

A Phase 4 study testing Nicotine Replacement Therapy, Bupropion and Cognitive Behavioral Treatment in people with Smoking Cessation and Alcohol Drinking, run by Duke University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Alcohol misuse and smoking constitute two of the three leading preventable causes of death in the United States. The purpose of this research study is to develop an intervention designed to help people stop drinking alcohol and stop smoking at the same time. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Smoking Cessation, Alcohol Drinking
What is being tested?
Nicotine Replacement Therapy, Bupropion and Cognitive Behavioral Treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteUnited States
Study dates
Nov 2016to 2 Mar 2020
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • currently meet criteria for DSM-5 mild to moderate alcohol use disorder (meeting 2-5 criteria for AUD)
  • have been engaging in hazardous drinking over the past month, defined as either exceeding a mean of 14 standard drinks/wk for men, 7 drinks/wk for women; or by consuming >5 on at least one occasion in the last month for men, >4 drinks on at least one occasion in the last month for women
  • currently smoke >10 cigarettes a day, and have smoked for at least one year
  • can speak and write fluent conversational English
  • are willing to make an attempt to quit both alcohol and smoking

Who cannot join

  • are expected to have unstable medication regimen during the study
  • are currently receiving non-study behavioral treatment for alcohol use disorder or smoking
  • have severe alcohol use disorder (meeting >6 criteria for AUD or having alcohol withdrawal symptom criterion)
  • have AUD that is in early remission, with no symptoms evident over the past month
  • have experienced myocardial infarction in past 6 months
  • contraindication to nicotine replacement therapy with no medical clearance to participate in the study
Show all 11Show fewer
  • use other forms of nicotine such as cigars, pipes, or chewing tobacco
  • are currently pregnant
  • have a primary psychotic disorder or current manic episode
  • have had substance use disorder (other than alcohol or nicotine) in the preceding 3 months
  • are currently imprisoned or in psychiatric hospitalization

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Duke University Medical Center

    Durham, North Carolina, 27706

Other trials in United States

About this study

Alcohol misuse and smoking constitute two of the three leading preventable causes of death in the United States. The purpose of this research study is to develop an intervention designed to help people stop drinking alcohol and stop smoking at the same time.

Read the detailed description

Alcohol misuse and smoking constitute two of the three leading preventable causes of death in the United States. Reluctance to treat tobacco dependence among those with AUD is misguided as recent research suggests smoking cessation treatment can be effective, does not increase risk of relapse to alcohol, and may even improve rates of sobriety. There is strong evidence for the short-term efficacy for alcohol misuse and smoking of contingency management (CM). It is an intensive behavioral therapy that provides incentives (vouchers, money) to individuals misusing substances contingent upon objective evidence from drug use. Implementation of CM has been limited because of the need to verify abstinence multiple times daily using clinic based monitoring. The investigators recently developed a smart-phone application which allows a patient to video themselves several times daily while using a small CO monitor and to transmit the data to a secure server which has made the use of CM for outpatient smoking cessation portable and feasible. This mobile CM (mCM) approach paired with cognitive-behavioral counseling and pharmacological smoking cessation aids has been effective in reducing smoking.

Thus, the purpose of this project is to develop a combined alcohol and smoking mCM intervention. The intervention will be developed in two successive cohorts of five participants, who will provide information on treatment acceptability and feasibility. A third cohort of participants (n=45) will participate in a randomized clinical trials to further examine feasibility and efficacy. The long term goal is to develop mCM procedures that will be used as part of a multi-component intervention to concurrently and effectively treat both alcohol misuse and smoking. As part of this project, the investigators will develop a multi-component telehealth alcohol and smoking mCM intervention. It will include mCM, cognitive-behavioral phone counseling, and standard smoking cessation pharmacotherapy. The work proposed in these aims will provide the first step toward implementation of an innovative approach that builds upon the power of mHealth technology to reduce the prevalence of both alcohol misuse and smoking.

Being tested
Nicotine Replacement Therapy, Bupropion, Cognitive Behavioral Treatment, Mobile Contingency Management, Mobile Monitoring
Medical subject headings
Smoking Cessation, Alcohol Drinking

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nicotine Replacement TherapyOther

    Also called nicotine gum, patch, inhaler, and/or lozenge

    Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or nicotine lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings

  • BupropionDrug

    Also called Zyban

    All participants who are medically eligible will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up.

  • Cognitive Behavioral TreatmentBehavioural

    Also called CBT

    Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation.

  • Mobile Contingency ManagementBehavioural

    Also called mobile CM, mCM

    Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.

  • Mobile MonitoringBehavioural

    Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.

Study groups in NCT02995915
Study groupRoleWhat they receive
Tele-health Mobile Contingency Management InterventionExperimentalThis arm includes a proactive tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, a tele-medicine clinic for access to smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM).
Receives: Other: Nicotine Replacement Therapy; Drug: Bupropion; Behavioral: Cognitive Behavioral Treatment; Behavioral: Mobile Contingency Management
Tele-health for Alcohol and Smoking CessationActive comparatorThis arm includes a proactive tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and tele-medicine clinic for access to smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants will receive monetary compensation for each assessment, regardless of abstinence.
Receives: Other: Nicotine Replacement Therapy; Drug: Bupropion; Behavioral: Cognitive Behavioral Treatment; Behavioral: Mobile Monitoring

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Self-report Prolonged Abstinence From Smoking

    Participants will be asked to report on smoking since two weeks past quit date

    Measured: 6 month follow-up

  2. Number of Participants Whose Prolonged Abstinence From Smoking is Bio-verified

    Self-reported prolonged abstinence (primary outcome) will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.

    Measured: 6 month follow-up

  3. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use

    Participants will be asked to report on alcohol use since two weeks past quit date

    Measured: 6 month follow-up

  4. Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified

    Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

    Measured: 6 month follow-up

  5. Number of Participants Who Self-report Prolonged Dual Abstinence From Both Smoking and Alcohol

    Participants will be asked to report on smoking and alcohol use since two weeks past quit date

    Measured: 6 month follow-up

  6. Number of Participants Whose Prolonged Dual Abstinence From Alcohol and Smoking is Bio-verified

    Self-reported prolonged abstinence from smoking will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

    Measured: 6 month follow-up

Secondary outcomes (20)
  1. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking

    7-day point prevalence abstinence is defined as no smoking in the prior 7 days.

    Measured: 6 month follow-up

  2. Number of Participants Who Report 30 Day Point Prevalence Abstinence From Smoking

    30-day point prevalence abstinence is defined as no smoking in the prior 30 days

    Measured: 6 month follow-up

  3. Change in the Proportion of Days in Which Consumed Alcohol Compared to Pre-quit Use

    Participants will self-report number of days drank alcohol in the past 30 days and this will be compared to self-reported number of days drank alcohol in 30 days prior to quit.

    Measured: 6 month follow-up

  4. Change in the Number of Standard Alcoholic Beverages Consumed Per Week Compared to Pre-quit Use

    Participants will self-report number of alcoholic beverages consumed in past 7 days and this will be compared to self-reported number of alcoholic beverages consumed in 7 days prior to quit.

    Measured: 6 month follow-up

  5. Change in the Number of Heavy Drinking Episodes Compared to Pre-quit Use

    Participants will self-report number of heavy drinking episodes in the past 30 days and this will be compared to self-reported number of heavy drinking episodes in 30 days prior to quit.

    Measured: 6 month follow-up

  6. Number of Participants Who Are Able to Achieve Recommended Drinking Limits (i.e., Less Than or Equal to 14 Drinks Per Week and Fewer Than 5 Drinks Per Day for Men; Less Than or Equal to 7 Days Per Week and Less Than 4 Drinks Per Day for Women)

    Participants will be asked to report on alcohol use in past week

    Measured: 6 month follow-up

  7. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use

    Participants will be asked to report on alcohol use since two weeks past quit date

    Measured: 6 week follow-up (i.e., end of treatment visit)

  8. Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified

    Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

    Measured: 6 week follow-up (i.e., end of treatment visit)

  9. Change in Number of Average Cigarettes Smoked Per Day

    Participants will self-report average number of cigarettes smoked in the past week and this will be compared to self-reported number of smoked in the week prior to quit.

    Measured: 6 month follow-up

  10. Change in the Proportion of Days in Which Smoked Compared to Pre-quit Use

    Participants will self-report number of days smoked in the past 30 days and this will be compared to self-reported number of days smoked 30 days prior to quit.

    Measured: 6 month follow-up

  11. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking

    Participants will be asked to report on smoking since two weeks past quit date

    Measured: 6 week follow-up (i.e., end of treatment visit)

  12. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking

    Participants will be asked to report on smoking since two weeks past quit date

    Measured: 8 week follow-up (i.e., Session 7, end of monitoring visit)

  13. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use

    Participants will be asked to report on alcohol use since two weeks past quit

    Measured: 8 week follow-up (i.e., Session 7, end of monitoring visit)

  14. Number of Participants Who Self-report Prolonged Abstinence From Smoking

    Participants will be asked to report on alcohol use since two weeks past quit

    Measured: 6 week follow-up (i.e., end of treatment visit)

  15. Number of Participants Who Self-report Prolonged Abstinence From Smoking

    Participants will be asked to report on alcohol use since two weeks past quit

    Measured: 8 week follow-up (i.e., Session 7, end of monitoring visit)

  16. Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking

    Participants will be asked to report on smoking since two weeks past quit date

    Measured: 6 week follow-up (i.e., end of treatment visit)

  17. Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking

    Participants will be asked to report on smoking since two weeks past quit date

    Measured: 8 week follow-up (i.e., Session 7, end of monitoring visit)

  18. Number of Smoking Quit Attempts

    Participants will be asked to report the number of quit attempts made since quit date

    Measured: 6 week follow-up (i.e., end of treatment visit)

  19. Number of Smoking Quit Attempts

    Participants will be asked to report the number of quit attempts made since quit date

    Measured: 8 week follow-up (i.e., Session 7, end of monitoring visit)

  20. Number of Smoking Quit Attempts

    Participants will be asked to report the number of quit attempts made since quit date

    Measured: 6-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Dec 2016 (estimated)
  2. Study startNov 2016
  3. Primary completion2 Mar 2020
  4. Study completion2 Mar 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02995915
Sponsor's protocol ID
Pro00062101
Status last verified
Apr 2021
First submitted
14 Dec 2016
Last updated
28 Apr 2021
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Nicotine Replacement Therapy, Bupropion and Cognitive Behavioral Treatment in people with Smoking Cessation and Alcohol Drinking, run by Duke University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Self-report Prolonged Abstinence From Smoking (time frame: 6 month follow-up). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2021.

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