Facilitation Strategy for Tobacco Use Disorder

(FITT Trial)

This trial aims to help Veterans with serious mental illness who smoke quit by increasing the frequency of tobacco cessation medication prescriptions by doctors. Veterans with mental illness smoke at higher rates and face greater health risks. The trial will test a "multi-component facilitation strategy" to encourage mental health providers to offer these medications more often. Veterans who have recently visited specific mental health clinics, have a serious mental illness, and currently smoke might be a good fit. As an unphased trial, this study offers Veterans the opportunity to contribute to important research that could improve healthcare practices.

The trial does not specify if you need to stop taking your current medications, but if you are already taking bupropion, varenicline, or any nicotine replacement therapy, you cannot participate.

Previous studies have shown promising results when using multiple methods to help people quit smoking. Research indicates that these approaches can assist more individuals in stopping smoking compared to simpler methods. For instance, one study found that 40.4% of participants quit smoking after using a multi-method approach.

These methods often include activities such as educational sessions, feedback on progress, and training. They have been shown to not only aid in quitting smoking but also improve attitudes and beliefs about smoking.

Researchers are excited about the multi-component facilitation strategy for tobacco use disorder because it offers a comprehensive approach that addresses multiple aspects of quitting smoking. Unlike traditional treatments that focus solely on medication or counseling, this strategy includes external facilitation to enhance educational outreach, performance auditing, training, and veteran outreach. By incorporating a team-based approach with dedicated champions and regular implementation meetings, it aims to create a more supportive and personalized environment for individuals attempting to quit smoking. This could potentially lead to higher success rates and a more sustainable path to quitting tobacco.

Research has shown that combining several methods can significantly aid smoking cessation. In this trial, participants will receive a multi-component external facilitation strategy. This involves an external facilitator supporting various activities, such as educational outreach, auditing performance, and providing feedback. One study found that these combined approaches increased the number of people who remained smoke-free for at least seven days. Another study demonstrated that using multiple methods led to higher quit rates at both six months and a year later. Additionally, digital tools and apps improved quitting rates by 56% compared to usual methods. These findings suggest that combining different strategies can effectively help people quit smoking, particularly those who struggle to stop.²⁶⁷⁸⁹