The END Perioperative Smoking Pilot Study
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ClinicalTrials.gov Identifier: NCT02482233 |
Recruitment Status :
Completed
First Posted : June 26, 2015
Results First Posted : January 25, 2019
Last Update Posted : March 9, 2022
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Smoking Nicotine Addiction Surgery | Behavioral: ENDD (NJOY) Drug: NRT (NicoDerm CQ) Behavioral: telephone counseling Behavioral: brief advice Behavioral: brochure | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 30 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | A Pilot Randomized Controlled Clinical Trial - "Electronic Nicotine Delivery Device (E-cigarette) for Perioperative Smoking Cessation in Veterans" |
Study Start Date : | August 2015 |
Actual Primary Completion Date : | May 2016 |
Actual Study Completion Date : | September 2016 |
Arm | Intervention/treatment |
---|---|
Experimental: ENDD
6-week supply of disposable "NJOY" ENDDs (e-cigarettes)
Both groups will receive: i) referral to the California Smokers' Helpline, ii) brief advice lasting less than 2 minutes, iii) a brochure from the ASA about quitting smoking before surgery |
Behavioral: ENDD (NJOY)
As described above.
Other Names:
Behavioral: telephone counseling Referral to the California Smokers' Helpline. California Smokers' Helpline will call the patient 4 times, or as agreed upon by the patient. Behavioral: brief advice Brief advice lasting less than 2 minutes will be delivered by the research assistant, investigator, or healthcare provider. The advice will be similar to the following statement (customized as needed to the patient): "The most important advice I can give you is that quitting smoking is the number one thing you can do for your health and to prepare yourself for surgery. Quitting smoking before surgery may improve your chances of healing quickly. There's evidence that the longer you quit before your surgery, the fewer complications you'll have. I encourage you to make use of the resources that have been provided to you to help you quit and set your quit date for as soon as possible." Behavioral: brochure A brochure from the ASA (American Society of Anesthesiologists) about quitting smoking before surgery. Available free from the ASA: http://ecommerce.asahq.org/publicationsAndServices/PatientBrochure_%20For%20Posting.pdf |
Active Comparator: NRT (NicoDerm CQ)
A prescription for 6 weeks of transdermal nicotine replacement (on-formulary at the VA) in the following doses: For smokers of 10 cigarettes per day or more, a 3-week supply of 21 mg/d, 1-week supply of 14 mg/d, 1-week supply of 7 mg/d, and 1-week of 0mg/d. Smokers of <10 cigarettes per day, 3 weeks of 14 mg/d patches 2 weeks of 7 mg/d patches, and 1-week of 0mg/d. Both groups will receive: i) referral to the California Smokers' Helpline, ii) brief advice lasting less than 2 minutes, iii) a brochure from the ASA about quitting smoking before surgery |
Drug: NRT (NicoDerm CQ)
As described above.
Other Name: nicotine patch Behavioral: telephone counseling Referral to the California Smokers' Helpline. California Smokers' Helpline will call the patient 4 times, or as agreed upon by the patient. Behavioral: brief advice Brief advice lasting less than 2 minutes will be delivered by the research assistant, investigator, or healthcare provider. The advice will be similar to the following statement (customized as needed to the patient): "The most important advice I can give you is that quitting smoking is the number one thing you can do for your health and to prepare yourself for surgery. Quitting smoking before surgery may improve your chances of healing quickly. There's evidence that the longer you quit before your surgery, the fewer complications you'll have. I encourage you to make use of the resources that have been provided to you to help you quit and set your quit date for as soon as possible." Behavioral: brochure A brochure from the ASA (American Society of Anesthesiologists) about quitting smoking before surgery. Available free from the ASA: http://ecommerce.asahq.org/publicationsAndServices/PatientBrochure_%20For%20Posting.pdf |
- Smoking Status on the Day of Surgery (48-hour Point-prevalence Abstinence), by Self-report and Confirmed With Exhaled Carbon Monoxide (CO) [ Time Frame: day of surgery (expected average around 1-2 weeks after enrollment/randomization) ]
Confirmed abstinent. Abstinence confirmed with exhaled carbon monoxoide <10ppm.
Time Frame depends on date of preadmission clinic visit
- Frequency of Use of Product - Number Reporting Use Daily or Most Days [ Time Frame: 8-weeks ]
how often product (e-cigarette or patch) was used (everyday except while hospitalized, most days, a few times a week, once a week, less than once a week, not at all)
Result reported is those that used the product daily or most days
- Report of How Helpful the Product Was for Quitting [ Time Frame: 8-weeks ]
7-point likert scale (strongly disagree to strongly agree)
- strongly disagree
- disagree
- disagree somewhat
- neither agree nor disagree
- agree somewhat
- agree
- strongly agree
- How Satisfied the Patient Was With the Product (E-cigarette or Patch) [ Time Frame: 8-weeks ]
7-point likert scale (strongly disagree to strongly agree)
- strongly disagree
- disagree
- disagree somewhat
- neither agree nor disagree
- agree somewhat
- agree
- strongly agree
- How Likely the Patient Would be to Recommend the Product (E-cigarette or Patch) to Others [ Time Frame: 8-weeks ]
7-point likert scale (strongly disagree to strongly agree)
- strongly disagree
- disagree
- disagree somewhat
- neither agree nor disagree
- agree somewhat
- agree
- strongly agree
- Smoking Status 8-weeks After Randomization (Confirmed by Exhaled CO) [ Time Frame: 8-weeks ]by self-report and confirmed by exhaled CO<10ppm - confirmed abstinent
- Smoking Reduction [ Time Frame: on day of surgery and 8-weeks after randomization ]50% or less regular cigarette use compared to baseline as determined by asking participants to self-report daily cigarette use in cigarettes per day at each time point.
- Number of Participants With Dual Use [ Time Frame: on day of surgery and 8-weeks after randomization ]use of both regular and e-cigarettes concurrently
- Spirometry - FEV1/FVC Change [ Time Frame: day of surgery and 8-weeks ]Change in FEV1/FVC from baseline to day of surgery / 8-weeks. FEV1/FVC is expressed in percent. For example, if FEV1/FVC was 75%, 80%, and 85% at baseline, day of surgery and 8-weeks, result is reported as change in FEV1/FVC being +5% and +10% for day of surgery and 8-weeks respectively.
- Spirometry - FEV1 [ Time Frame: day of surgery and 8-weeks ]change in FEV1 (mL) compared to baseline
- Cotinine Level (Change in) [ Time Frame: day of surgery and 8-weeks ]salivary
- Number of Participants With Postoperative Complications (Composite) [ Time Frame: 30-days postop ]by chart review - research assistant or investigator examined notes and investigations postoperatively for complications by telephone self-report - patients were asked open-ended question about whether they experienced any postoperative complications
- Long-term Smoking Status - Use of Conventional Cigarettes [ Time Frame: 6 months ]by self-report (7-day point prevalence)
- Number of Participants With Adverse Events as a Measure of Safety and Tolerability [ Time Frame: 8 weeks ]all patients will be asked about adverse events each time they are contacted (day of surgery, 30-days postoperatively, and 8-weeks after randomization), and they will also be able to call to report adverse events to the study team any time during the study.
- Number of Participants Postoperative Complications (Composite) [ Time Frame: 30-days postop ]by telephone self-report
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- adults (age >18)
- any gender
- scheduled to undergo elective surgery at the San Francisco Veterans Affairs Medical Center (SFVAMC)
- daily smoker, based on self-report of at least 2 cigarettes/day and having smoked in the last 7 days
- presenting to the anesthesia preoperative (APO) clinic at least 3 days preoperatively
Exclusion Criteria:
- emergency surgery (booked <24 hours preoperatively)
- consumers of non-cigarette forms of tobacco only (pipe, smokeless tobacco) or marijuana only
- already enrolled in a smoking cessation trial
- current smoking cessation pharmacotherapy
- daily user of e-cigarettes
- previous adverse reaction to e-cigarette or transdermal nicotine
- poor proficiency of English language¸as indicated by need for an interpreter (including family members) at the preadmission visit
- lacking capacity for consent (e.g. due to mental illness or dementia), as indicated by consent for surgery and other medical procedures being obtained from a substitute decision maker
- pregnant or breastfeeding
- unstable cardiac condition (unstable angina, unstable arrhythmia)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02482233
United States, California | |
San Francisco VA Medical Center | |
San Francisco, California, United States, 94121 |
Principal Investigator: | Susan M Lee, MD, MAS | UCSF / SFVAMC |
Publications of Results:
Responsible Party: | University of California, San Francisco |
ClinicalTrials.gov Identifier: | NCT02482233 |
Other Study ID Numbers: |
14-15274 |
First Posted: | June 26, 2015 Key Record Dates |
Results First Posted: | January 25, 2019 |
Last Update Posted: | March 9, 2022 |
Last Verified: | March 2022 |
electronic cigarette nicotine replacement therapy smoking cessation perioperative |
Tobacco Use Disorder Substance-Related Disorders Chemically-Induced Disorders Mental Disorders Nicotine Ganglionic Stimulants Autonomic Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Nicotinic Agonists Cholinergic Agonists Cholinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |