Randomized Trial of Interventions for Smoking Cessation Among Medicaid Beneficiaries With Mental Illness
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Study Sites
Participants
Procedures
Interventions
Program coordinators.
Motivational tobacco education.
Usual care prescriber visit for smoking cessation.
Cessation condition 1: usual care PV only (PV only).
Cessation condition 2: PV plus facilitated quitline counseling (PV+Q).
Cessation condition 3: PV plus CBT (PV+CBT).
Incentives for smoking abstinence.
Measures
Abstinence.
Other smoking-related measures.
Mental and general medical health measures.
Participant Flow
Statistical Analyses
Descriptive analyses.
Stratum effect.
Outcome analyses.
Safety analyses.
Results
Study Participants
Total sample (N=661) | PV only (N=146) | PV+Q (N=303) | PV+CBT (N=212) | |||||
---|---|---|---|---|---|---|---|---|
Characteristic | N | % | N | % | N | % | N | % |
Age (M±SD)b | 45.0±10.8 | 43.0±10.8 | 45.0±10.7 | 46±11.0 | ||||
Female | 426 | 64 | 82 | 56 | 200 | 66 | 144 | 67 |
White | 610 | 93 | 131 | 91 | 821 | 93 | 198 | 93 |
High school graduate | 549 | 83 | 116 | 80 | 247 | 81 | 186 | 87 |
Not employed | 545 | 82 | 113 | 77 | 258 | 85 | 174 | 81 |
Diagnosis | ||||||||
Schizophrenia spectrum disorder | 148 | 22 | 31 | 21 | 74 | 24 | 43 | 20 |
Bipolar disorder | 150 | 23 | 29 | 20 | 68 | 22 | 56 | 26 |
Major depression | 158 | 24 | 36 | 25 | 69 | 23 | 53 | 25 |
Anxiety and other disorders | 205 | 31 | 50 | 34 | 94 | 31 | 62 | 29 |
Modified Colorado Symptom Index score (M±SD)c | 49.1±10.9 | 49.5±11.9 | 49.0±10.8 | 48.0±10.2 | ||||
Lifetime psychiatric hospitalizations (M±SD) | 8.3±26.9 | 6.0±15.4 | 9.0±34.7 | 9.0±19.0 | ||||
Blood pressure category | ||||||||
Prehypertension | 303 | 46 | 61 | 42 | 147 | 49 | 95 | 45 |
Hypertension | 170 | 26 | 45 | 31 | 73 | 24 | 52 | 25 |
Obese | 371 | 56 | 90 | 62 | 160 | 53 | 121 | 57 |
Tobacco use | ||||||||
Breath carbon monoxide (M±SD ppm)d | 25.3±16.9 | 25.0±17.3 | 27.0±16.8 | 24.0±16.8 | ||||
Fagerström Test for Nicotine Dependence score (M±SD)e | 5.3±2.3 | 5.0±2.4 | 5.0±2.1 | 6.0±2.4 | ||||
Cigarettes smoked per day (M±SD)b | 17.3±10.5 | 16.0±10.9 | 18.0±10.2 | 17.0±10.5 | ||||
Quit attempt in past year | 347 | 52 | 69 | 47 | 155 | 51 | 123 | 58 |
Confidence in quitting score (M±SD)f | 3.7±1.2 | 4.0±1.2 | 4.0±1.2 | 4.0±1.2 |
Treatment Outcomes
![](/cms/10.1176/appi.ps.201700245/asset/images/large/appi.ps.201700245f1.jpeg)
![](/cms/10.1176/appi.ps.201700245/asset/images/large/appi.ps.201700245f2.jpeg)
Treatment Safety
Treatment Program Participation
Discussion
Conclusions
Acknowledgments
Footnote
Supplementary Material
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Cover: Flying Geese, by Felix Bracquemond, 19th century. Black chalk, brush, and watercolor, highlighted with white gouache. Museum purchase, Davis Museum, Welleseley College. Photo credit: Davis Museum/Art Resource, New York City.
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Authors
Competing Interests
Funding Information
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