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Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: A Patient-Randomized Controlled Trial.
Am J Prev Med. 2016 Apr; 50(4):518-527.AJ

Abstract

INTRODUCTION

People with a mental health diagnosis have high rates of tobacco use and encounter limited availability of tobacco treatment targeted to their needs. This study compared the effectiveness of a specialized telephone smoking-cessation intervention developed for mental health patients with standard state quit-line counseling.

DESIGN

RCT.

SETTING/PARTICIPANTS

The study was conducted at six Veterans Health Administration facilities in the Northeast U.S. Participants were 577 mental health clinic patients referred by their providers for smoking-cessation treatment.

INTERVENTION

From 2010 to 2012, the study implemented a telephone program that included patient referral from a mental health provider, mailed cessation medications, and telephone counseling. Participants were randomized to receive a specialized multisession telephone counseling protocol (n=270) or transfer to their state's quit-line for counseling (n=307).

MAIN OUTCOME MEASURES

Participants completed telephone surveys at baseline, 2 months, and 6 months. The study's primary outcome was self-reported 30-day abstinence at 6 months. Secondary outcomes were self-reported 30-day abstinence, counseling satisfaction and counseling content at 2 months, and self-reported use of cessation treatment and quit attempts at 6 months. Logistic regression was used to compare treatment groups on outcomes, controlling for baseline cigarettes per day and site. Inverse probability weighting and multiple imputation were used to handle missing abstinence outcomes. Data were analyzed in 2014-2015.

RESULTS

At 6 months, participants in the specialized counseling arm were more likely to report 30-day abstinence (26% vs 18%, OR=1.62, 95% CI=1.24, 2.11). There was no significant group difference in abstinence at 2 months (18% vs 14%, OR=1.31, 95% CI=0.49, 3.49). Participants in the specialized arm were more likely to be assisted with developing a quit plan; receive follow-up calls after quitting; and receive counseling on several domains, including motivation, confidence, smoking triggers, coping with urges, and mental health symptoms (all p<0.05). Specialized counseling participants were more satisfied with treatment and more likely to find the counseling useful (p<0.05).

CONCLUSIONS

The specialized counseling intervention was more effective at helping patients quit than transfer to a state quit-line. Patients were more satisfied with the specialized counseling program.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT00724308.

Authors+Show Affiliations

VA NY Harbor Healthcare System, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: erin.rogers2@va.gov.Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts; University of Massachusetts Medical School, Worcester, Massachusetts.VA NY Harbor Healthcare System, New York, New York; Division of General Internal Medicine, New York University School of Medicine, New York, New York.Department of Population Health, New York University School of Medicine, New York, New York.California Breast Cancer Research Program, University of California Office of the President, Oakland, California.Minneapolis VA Medical Center, Minneapolis, Minnesota; Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, Minnesota.University of Massachusetts Medical School, Worcester, Massachusetts.VA NY Harbor Healthcare System, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York.Department of Population Health, New York University School of Medicine, New York, New York.Department of Population Health, New York University School of Medicine, New York, New York.VA NY Harbor Healthcare System, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26711163

Citation

Rogers, Erin S., et al. "Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: a Patient-Randomized Controlled Trial." American Journal of Preventive Medicine, vol. 50, no. 4, 2016, pp. 518-527.
Rogers ES, Smelson DA, Gillespie CC, et al. Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: A Patient-Randomized Controlled Trial. Am J Prev Med. 2016;50(4):518-527.
Rogers, E. S., Smelson, D. A., Gillespie, C. C., Elbel, B., Poole, S., Hagedorn, H. J., Kalman, D., Krebs, P., Fang, Y., Wang, B., & Sherman, S. E. (2016). Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: A Patient-Randomized Controlled Trial. American Journal of Preventive Medicine, 50(4), 518-527. https://doi.org/10.1016/j.amepre.2015.10.004
Rogers ES, et al. Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: a Patient-Randomized Controlled Trial. Am J Prev Med. 2016;50(4):518-527. PubMed PMID: 26711163.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: A Patient-Randomized Controlled Trial. AU - Rogers,Erin S, AU - Smelson,David A, AU - Gillespie,Colleen C, AU - Elbel,Brian, AU - Poole,Senaida, AU - Hagedorn,Hildi J, AU - Kalman,David, AU - Krebs,Paul, AU - Fang,Yixin, AU - Wang,Binhuan, AU - Sherman,Scott E, Y1 - 2015/12/17/ PY - 2015/04/30/received PY - 2015/09/24/revised PY - 2015/10/08/accepted PY - 2015/12/30/entrez PY - 2015/12/30/pubmed PY - 2017/1/4/medline SP - 518 EP - 527 JF - American journal of preventive medicine JO - Am J Prev Med VL - 50 IS - 4 N2 - INTRODUCTION: People with a mental health diagnosis have high rates of tobacco use and encounter limited availability of tobacco treatment targeted to their needs. This study compared the effectiveness of a specialized telephone smoking-cessation intervention developed for mental health patients with standard state quit-line counseling. DESIGN: RCT. SETTING/PARTICIPANTS: The study was conducted at six Veterans Health Administration facilities in the Northeast U.S. Participants were 577 mental health clinic patients referred by their providers for smoking-cessation treatment. INTERVENTION: From 2010 to 2012, the study implemented a telephone program that included patient referral from a mental health provider, mailed cessation medications, and telephone counseling. Participants were randomized to receive a specialized multisession telephone counseling protocol (n=270) or transfer to their state's quit-line for counseling (n=307). MAIN OUTCOME MEASURES: Participants completed telephone surveys at baseline, 2 months, and 6 months. The study's primary outcome was self-reported 30-day abstinence at 6 months. Secondary outcomes were self-reported 30-day abstinence, counseling satisfaction and counseling content at 2 months, and self-reported use of cessation treatment and quit attempts at 6 months. Logistic regression was used to compare treatment groups on outcomes, controlling for baseline cigarettes per day and site. Inverse probability weighting and multiple imputation were used to handle missing abstinence outcomes. Data were analyzed in 2014-2015. RESULTS: At 6 months, participants in the specialized counseling arm were more likely to report 30-day abstinence (26% vs 18%, OR=1.62, 95% CI=1.24, 2.11). There was no significant group difference in abstinence at 2 months (18% vs 14%, OR=1.31, 95% CI=0.49, 3.49). Participants in the specialized arm were more likely to be assisted with developing a quit plan; receive follow-up calls after quitting; and receive counseling on several domains, including motivation, confidence, smoking triggers, coping with urges, and mental health symptoms (all p<0.05). Specialized counseling participants were more satisfied with treatment and more likely to find the counseling useful (p<0.05). CONCLUSIONS: The specialized counseling intervention was more effective at helping patients quit than transfer to a state quit-line. Patients were more satisfied with the specialized counseling program. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT00724308. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/26711163/Telephone_Smoking_Cessation_Counseling_for_Smokers_in_Mental_Health_Clinics:_A_Patient_Randomized_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(15)00681-9 DB - PRIME DP - Unbound Medicine ER -