A Qualitative Evaluation of Knowledge of and Attitudes toward VA Smoking Cessation Services

Cunningham, Cassie; Kaboli, Peter J.; Ono, Sarah S.; Weg, Mark W. Vander

doi:10.1375/jsc.6.2.152

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…3,4 Both bupropion and nicotine replacement therapy have been found to be more effective than placebo or no treatment, 5,6 but they are ineffective in many cases. In fact, a meta-analysis of clinical trials found that bupropion and a nicotine patch result in abstinence in only 20% and 13% of participants, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria were age 19 years or older and currently smoking Ն10 cigarettes per day. Study exclusions included (1) pathologic condition of the ear; (2) pregnancy; (3) indwelling cardiac pacemaker or defibrillator; (4) actively psychotic, severe cognitive impairment, or current significant substance abuse disorder; and (5) currently receiving another intervention for smoking cessation.…”

Section: Recruitment and Eligibility Screeningmentioning

confidence: 99%

“…2 In keeping with the 2008 clinical guidelines for smoking cessation, veterans are asked about their smoking status annually and are offered group or individual counseling and either bupropion or nicotine replacement therapy to help them achieve smoking abstinence. 3,4 Both bupropion and nicotine replacement therapy have been found to be more effective than placebo or no treatment, 5,6 but they are ineffective in many cases. In fact, a meta-analysis of clinical trials found that bupropion and a nicotine patch result in abstinence in only 20% and 13% of participants, respectively.…”

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confidence: 99%

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The Efficacy of Auriculotherapy for Smoking Cessation: A Randomized, Placebo-Controlled Trial

Fritz¹,

Carney²,

Steinmeyer³

et al. 2013

The Journal of the American Board of Family Medicine

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Background: Quitting smoking remains a challenge for almost one-third of the military veteran population. Alternatives to pharmacological therapies such as acupuncture, acupressure, and electrical stimulation have received minimal attention in research but have been widely reported to be popular and safe interventions for smoking cessation.Methods: This randomized, double-blind, placebo-controlled clinical trial of 125 veterans was conducted to determine whether aural electrical stimulation (auriculotherapy) once a week for 5 consecutive weeks is associated with a higher rate of smoking abstinence are than observed with sham stimulation.Results: Auriculotherapy was found to be safe and largely free from significant side effects. However, there was no difference in the rate of smoking cessation between those participants who received true auriculotherapy and those who received sham auriculotherapy. The auriculotherapy group achieved a rate of 20.9% abstinence versus 17.9% for the placebo arm after 6 weeks. Conclusion:The results of this randomized, controlled clinical trial do not support the use of auriculotherapy to assist with smoking cessation. It is possible that a longer treatment duration, more frequent sessions, or other modifications of the intervention protocol used in this study may result in a different outcome. However, based on the results of this study, there is no evidence that auriculotherapy is superior to placebo when offered once a week for 5 weeks, as described in previous uncontrolled studies. ( Smoking is a major health hazard. Although the risk of smoking-related diseases and death decline sharply when smokers quit, 19% of Americans currently smoke.1 Rates of smoking are even higher among US military veterans, with about 1 in 3 current smokers.2 In keeping with the 2008 clinical guidelines for smoking cessation, veterans are asked about their smoking status annually and are offered group or individual counseling and either bupropion or nicotine replacement therapy to help them achieve smoking abstinence. 3,4 Both bupropion and nicotine replacement therapy have been found to be more effective than placebo or no treatment, 5,6 but they are ineffective in many cases. In fact, a meta-analysis of clinical trials found that bupropion and a nicotine patch result in abstinence in only 20% and 13% of participants, respectively.7 At the Veterans Affairs Medical Center (VAMC), varencline, a second-line medication with a reported 25% abstinence rate, is considered only after bupropion or nicotine replacement therapy or a combination of the two have failed, and then only after appropriate psychiatric and cardiovascular screening. [7][8][9][10][11][12] Alternatives to pharmacological therapies such as acupuncture, acupressure, and electrical stimulation have received minimal attention in the re- search but are used widely, and proponents of their use believe them to be effective and safe interventions for smoking. 13 However, a recent Cochrane review found little evidence from randomized controlled tria...

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Section: Discussionmentioning

confidence: 99%

Section: Recruitment and Eligibility Screeningmentioning

confidence: 99%

mentioning

confidence: 99%

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The Efficacy of Auriculotherapy for Smoking Cessation: A Randomized, Placebo-Controlled Trial

Fritz¹,

Carney²,

Steinmeyer³

et al. 2013

The Journal of the American Board of Family Medicine

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“…Health care-associated factors including limited access to treatment also appear to contribute [ 3 , 4 ]. Being uninsured [ 4 , 5 ], infrequent visits to and/or lack of a personal physician [ 4 , 5 ], a lower likelihood of being counseled about tobacco use [ 6 ], and insufficient knowledge about available treatment resources also likely play a role [ 4 , 7 ]. Considering that approximately 5.3 million Veterans, representing 24 % of all Veterans living in the US, reside in rural areas [ 8 ], this represents a substantial group of individuals who are at increased risk for smoking-related health problems.…”

Section: Introductionmentioning

confidence: 99%

An individually-tailored smoking cessation intervention for rural Veterans: a pilot randomized trial

Weg

Cozad²,

Howren

et al. 2016

BMC Public Health

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BackgroundTobacco use remains prevalent among Veterans of military service and those residing in rural areas. Smokers frequently experience tobacco-related issues including risky alcohol use, post-cessation weight gain, and depressive symptoms that may adversely impact their likelihood of quitting and maintaining abstinence. Telephone-based interventions that simultaneously address these issues may help to increase treatment access and improve outcomes.MethodsThis study was a two-group randomized controlled pilot trial. Participants were randomly assigned to an individually-tailored telephone tobacco intervention combining counseling for tobacco use and related issues including depressive symptoms, risky alcohol use, and weight concerns or to treatment provided through their state tobacco quitline. Selection of pharmacotherapy was based on medical history and a shared decision interview in both groups. Participants included 63 rural Veteran smokers (mean age = 56.8 years; 87 % male; mean number of cigarettes/day = 24.7). The primary outcome was self-reported 7-day point prevalence abstinence at 12 weeks and 6 months.ResultsTwelve-week quit rates based on an intention-to-treat analysis did not differ significantly by group (Tailored = 39 %; Quitline Referral = 25 %; odds ratio [OR]; 95 % confidence interval [CI] = 1.90; 0.56, 5.57). Six-month quit rates for the Tailored and Quitline Referral conditions were 29 and 28 %, respectively (OR; 95 % CI = 1.05; 0.35, 3.12). Satisfaction with the Tailored tobacco intervention was high.ConclusionsTelephone-based treatment that concomitantly addresses other health-related factors that may adversely affect quitting appears to be a promising strategy. Larger studies are needed to determine whether this approach improves cessation outcomes.Trial registrationClinicalTrials.gov identifier number NCT01592695 registered 11 April 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3493-z) contains supplementary material, which is available to authorized users.

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“…However, attendance at these VHA specialty smoking cessation clinics among all veterans is as low as 13% [12]. For rural veterans, the following extrinsic factors may negatively affect access to smoking cessation treatment: distance from health services, lack of health care follow-up, and lack of knowledge about smoking cessation resources [13, 14]. …”

Section: Introductionmentioning

confidence: 99%

A bstinence R einforcement T herapy (ART) for rural veterans: Methodology for an mHealth smoking cessation intervention

Wilson

Hair

Hertzberg

et al. 2016

Contemporary Clinical Trials

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Introduction Smoking is the most preventable cause of morbidity and mortality in U.S. veterans. Rural veterans in particular have elevated risk for smoking and smoking-related illness. However, these veterans underutilize smoking cessation treatment, which suggests that interventions for rural veterans should optimize efficacy and reach. Objective The primary goal of the current study is to evaluate the effectiveness of an intervention that combines evidenced based treatment for smoking cessation with smart-phone based, portable contingency management on smoking rates compared to a contact control intervention in a randomized controlled trial among rural Veteran smokers. Specifically, Veterans will be randomized to receive Abstinence Reinforcement Therapy (ART) which combines evidenced based cognitive-behavioral telephone counseling (TC), a tele-medicine clinic for access to nicotine replacement (NRT), and mobile contingency management (mCM) or a control condition (i.e., TC and NRT alone) that will provide controls for therapist, medication, time and attention effects. Methods Smokers were identified using VHA electronic medical records and recruited proactively via telephone. Participants (N = 310) are randomized to either ART or a best practice control consisting of telephone counseling and telemedicine. Participating patients will be surveyed at 3-months, 6-months and 12-months post-randomization. The primary outcome measure is self-reported and biochemically validated prolonged abstinence at 6-month follow-up. Discussion This trial is designed to test the relative effectiveness of ART compared to a telehealth-only comparison group. Dissemination of this mHealth intervention for veterans in a variety of settings would be warranted if ART improves smoking outcomes for rural veterans and is cost-effective.

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A Qualitative Evaluation of Knowledge of and Attitudes toward VA Smoking Cessation Services

Cited by 4 publications

References 6 publications

The Efficacy of Auriculotherapy for Smoking Cessation: A Randomized, Placebo-Controlled Trial

The Efficacy of Auriculotherapy for Smoking Cessation: A Randomized, Placebo-Controlled Trial

An individually-tailored smoking cessation intervention for rural Veterans: a pilot randomized trial

A bstinence R einforcement T herapy (ART) for rural veterans: Methodology for an mHealth smoking cessation intervention

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