Optimizing Tobacco Dependence Treatment in the Emergency Department

Summary

The investigators propose an innovative full-factorial design in a cohort of 1056 adult smokers in an urban emergency department (ED), to test the efficacy of four key intervention components: motivational interviewing, medication, quitline referral, and texting. At the trial's completion, a mixed-methods approach will be used to identify the components that were efficacious within the proposed cost constraint, along with feasibility and acceptability to providers and subjects. The investigators will then assemble an intervention that maximizes efficacy, given a cost-effectiveness constraint and findings from a qualitative analysis.

Timeline

Start

2017-02-13

Primary completion

2019-08-14

Completion

2019-08-14

Outcome

Mixed primary results

registry analysis (superiority test); Brief Negotiated Interview (BNI) vs Brief Negotiated Interview (BNI) CONTROL; p = .01; Odds Ratio (OR) 1.8 (95% CI 1.1 to 2.8); NCT02896400 ↗

registry analysis (superiority test); Nicotine Replacement Therapy (NRT) vs Nicotine Replacement Therapy (NRT) CONTROL; p = .001; Odds Ratio (OR) 2.1 (95% CI 1.3 to 3.2); NCT02896400 ↗

registry analysis (superiority test); Quitline (QL) vs Quitline (QL) CONTROL; p = 0.14; Odds Ratio (OR) 1.4 (95% CI 0.9 to 2.2); NCT02896400 ↗

registry analysis (superiority test); Text vs Text CONTROL; p = 0.64; Odds Ratio (OR) 1.1 (95% CI 0.7 to 1.7); NCT02896400 ↗

Publications

• Bernstein SL, Dziura J, Weiss J, Miller T, Vickerman KA, Grau LE, Pantalon MV, Abroms L, Collins LM, Toll B. Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy. Contemp Clin Trials. 2018 Mar;66:1-8. doi: 10.1016/j.cct.2017.12.016. Epub 2017 Dec 27.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Nicotine	Unknown	2 mg	—
Subject	Nicotine	Unknown	14 mg	—
Subject	Nicotine	Unknown	21 mg	—

Indications