Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Oct:69:19-27.
doi: 10.1016/j.jsat.2016.06.004. Epub 2016 Jun 17.

Comparative Effectiveness of an Internet-Based Smoking Cessation Intervention Versus Clinic-Based Specialty Care for Veterans

Patrick S Calhoun  1 , Santanu Datta  2 , Maren Olsen  3 , Valerie A Smith  4 , Scott D Moore  5 , Lauren P Hair  6 , Eric A Dedert  5 , Angela Kirby  5 , Michelle Dennis  7 , Jean C Beckham  5 , Lori A Bastian  8
Affiliations
Randomized Controlled Trial

Comparative Effectiveness of an Internet-Based Smoking Cessation Intervention Versus Clinic-Based Specialty Care for Veterans

Patrick S Calhoun et al. J Subst Abuse Treat. 2016 Oct.

Abstract

Introduction: The primary objective of this project was to examine the effectiveness of an Internet-based smoking cessation intervention combined with a tele-health medication clinic for nicotine replacement therapy (NRT) compared to referral to clinic-based smoking cessation care.

Methods: A total of 413 patients were proactively recruited from the Durham VA Medical Center and followed for 12 months. Patients were randomized to receive either a referral to VA specialty smoking cessation care (control) or to the Internet intervention and tele-health medication clinic. Primary outcomes included (1) intervention reach, (2) self-reported 7-day point prevalence abstinence rates at 3 months and 12 months, and 3) relative cost-effectiveness.

Results: Reach of the Internet intervention and use of smoking cessation aids were significantly greater compared to the control. At 3 months-post randomization, however, there were no significant differences in quit rates: 17% (95% CI: 12%–23%) in the Internet-based intervention compared to 12% (95% CI: 8%–17%) in the control arm. Similarly, there were no differences in quit rates at 12 months (13% vs. 16%). While costs associated with the Internet arm were higher due to increased penetration and intensity of NRT use, there were no statistically significant differences in the relative cost effectiveness (e.g., life years gained, quality adjusted life years) between the two arms.

Conclusions: Current results suggest that using an electronic medical record to identify smokers and proactively offering smoking cessation services that are consistent with US Public Health Guidelines can significantly reduce smoking in veterans. Novel interventions that increase the reach of intensive treatment are needed to maximize quit rates in this population.

Keywords: Internet intervention; Smoking cessation; Tele-health; Veterans.

PubMed Disclaimer

Conflict of interest statement

DECLARATION OF INTERESTS The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Consort Diagram
See this image and copyright information in PMC

References

    1. Abrams DB, Orleans CT, Niaura RS, Goldstein MG, Prochaska JO, Velicer W. Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: A combined stepped care and matching model. Annals of Behavioral Medicine. 1996;18:290–304. - PubMed
    1. Acheson SK, Straits-Troster K, Calhoun PS, Beckham JC, Hamlett-Berry K. Characteristics and correlates of tobacco use among U.S. veterans returning from Iraq and Afghanistan. Military Psychology. 2011;23(2):297–314. doi: 10.1080/08995605.2011.570589. - DOI
    1. Anderson EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale) American Journal of Preventative Medicine. 1994;10:77–84. - PubMed
    1. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale) Am J Prev Med. 1994;10(2):77–84. - PubMed
    1. Barlas FM, Higgins WB, Pflieger JC, Diecker K. 2011 Department of Defense health related behaviors survey of active duty military personnel. Fairfax, VA: 2013.

Publication types