Nicotine Replacement + Counseling for Smoking in Veterans

(Co-STOP Trial)

This trial tests a new program designed to assist Veterans struggling with both substance use and smoking. The program, called Co-STOP, combines nicotine replacement therapy (such as patches or gum) with counseling to determine if it encourages more people to attempt quitting smoking compared to the usual treatment. Participants may qualify if they smoke at least one cigarette daily, are in VA outpatient substance use treatment, and haven't recently tried smoking treatments. The research seeks to discover better ways to support Veterans in quitting smoking, potentially improving their overall health. As a Phase 4 trial, this study involves an FDA-approved treatment and aims to understand how it can benefit more patients.

Previous studies have shown that nicotine replacement therapy (NRT) is safe for those trying to quit smoking. The FDA has approved it, and doctors often recommend it as the first treatment option. Most people experience only mild side effects, such as skin irritation, headaches, or nausea. Importantly, NRT does not carry the harmful health effects associated with smoking cigarettes.

Research shows that combining NRT with counseling can improve the chances of quitting. Counseling provides support and strategies to manage cravings and withdrawal symptoms. Health experts often recommend this combination for effectively quitting smoking.

Researchers are excited about this trial because it explores a flexible approach to smoking cessation for veterans, incorporating Nicotine Replacement Therapy (NRT) with counseling without requiring an immediate commitment to quit. Unlike standard care, which primarily focuses on immediate cessation, this method allows participants to set manageable goals and use NRT to gradually reduce smoking, creating a more personalized and potentially less intimidating path to quitting. This approach not only targets the physical addiction but also addresses the behavioral aspects of smoking, offering a comprehensive support system that might increase the chances of long-term success.

Research has shown that nicotine replacement therapy (NRT) combined with counseling can significantly aid smokers in quitting. In this trial, participants in the Co-STOP arm will receive Healthy Changes treatment, which includes NRT and counseling to support their smoking cessation goals. Studies indicate that NRT can increase the chances of quitting by 50 to 70%. Veterans who received proactive support reported higher success rates in remaining smoke-free for a year. Additionally, using multiple types of NRT yields better results than using just one. Overall, NRT, particularly when paired with counseling, offers a strong opportunity for smokers to quit successfully.⁶⁷⁸⁹¹⁰