Smoking cessation navigation has not been tried as a strategy for increasing use of proven smoking cessation treatments such as nicotine replacement therapy (NRT) and telephone coaching support ("quitlines"). We propose a pilot study of this surprisingly innovative intervention to overcome psychosocial and practical barriers that keep low-income smokers from using NRT and quitlines. The intervention is modeled after existing navigation programs for patients to complete a defined course of medical treatment. The study will use a quasi-experimental design, comparing participant outcomes to those for demographically similar population-level quitline callers during the study period. The outcomes of immediate interest are rates of initiation and completion of proven cessation strategies, and biochemically validated abstinence rates. In addition, the pilot study will also collect qualitative data from participants about their perceptions and experiences in using NRT and quitline coaching. Finally, the pilot study will collect navigation cost data. Results of the pilot study will enable the research team to propose a site-randomized trial of smoking cessation navigation with a sub-study on cost- effectiveness. The long-term research question is whether smoking cessation navigation cost effectively increases quit attempts and initiation and completion of treatment using NRT and quit line coaching.

PUBLIC HEALTH RELEVANCE: Cigarette smoking is the leading cause of preventable death and disease. This study will try to help low- income smokers who want to quit, with information about quitting smoking, referral to free telephone coaches and nicotine patches, and a personal navigator to help them use the free services. If the strategy seems to work, a full scientific study will be proposed.

R21CA141569

2009-09-04

2012-08-31