Mobile smoking cessation program for Veterans undergoing surgery

Contingency Management for Veteran Smokers Undergoing Major Elective Surgery

This study is testing a mobile program to help Veterans quit smoking before surgery by offering rewards for staying smoke-free.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 36 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of California, San Francisco (Academic / other)
• Locations: 1 site (San Francisco, California)
• Trial ID: NCT06678672 on ClinicalTrials.gov

What this trial studies

This study aims to develop and test a mobile contingency management (CM) intervention designed to help military Veterans quit smoking before undergoing major elective surgery. Given that smoking significantly increases the risk of postoperative complications, the intervention will provide positive reinforcement through rewards for verified abstinence from smoking. The study will tailor the CM approach to the surgical context, ensuring it is feasible and effective for Veterans. By focusing on this high-risk population, the study seeks to improve surgical outcomes and reduce the incidence of complications associated with smoking.

Who should consider this trial

Good fit: Ideal candidates for this study are English-speaking Veterans enrolled in healthcare at the San Francisco VA Health Care System who are scheduled for major elective surgery and currently smoke at least two cigarettes per day.

Not a fit: Patients with unstable psychiatric or medical conditions, such as psychotic disorders or neurocognitive disorders, may not benefit from this study.

Why it matters

Potential benefit: If successful, this intervention could significantly reduce postoperative complications and mortality rates among Veterans who smoke.

How similar studies have performed: While contingency management has been effective in other smoking cessation contexts, this specific application in the perioperative setting for Veterans is novel and has not been previously tested.

Eligibility criteria

Inclusion Criteria:

* English-speaking;
* Veteran enrolled in healthcare at SFVAHCS;
* Veteran scheduled for major elective surgery within the next 6 months (including but not limited to: general, spinal, thoracic, vascular, urological, gynecological, orthopedic, gender affirming). Veterans, who are followed at SFVAHCS by Primary Care and are referred to outside institutions for major surgery (e.g., gynecological or gender-affirming surgeries) are also eligible to participate;
* Current (past 30 days) cigarette smoking a minimum of 1 cigarette per day (average), assessed by Timeline Followback (TLFB);
* Open to receiving smoking cessation interventions.

Exclusion Criteria:

Evaluated by investigative team medical record review and clinical assessment: - Psychotic disorders, bipolar disorder, neurocognitive disorder, or other psychiatric or medical conditions judged by the PI to be unstable based on medical record review and/or screening results;

* Untreated, current, active problem gambling, assessed by medical record diagnosis and/ or Problem Gambling Severity Index (PGSI) score ≥ 8;
* Enrollment in end of life/ palliative care;
* Surgery with a clinical indication for cancer;
* Unable to meet time commitment;
* Currently pregnant or planning to become pregnant during the study (people of childbearing potential ages 18-55);
* A suicide attempt or suicidal ideation with intent in the 30 days before enrollment;
* Concurrent participation in another tobacco cessation trial.

Where this trial is running

San Francisco, California

• San Francisco VA Health Care System — San Francisco, California, United States (Recruiting)

Study contacts

• Principal investigator: Ellen Herbst, MD — San Francisco VA Health Care System
• Study coordinator: Ellen Herbst, MD

Conditions Tobacco Use Disorder; Substance Use Disorder; Tobacco; Contingency Management; Surgery