A randomized trial to promote pharmacotherapy use and smoking cessation in a Medicaid population (United States).
OBJECTIVE
To evaluate the impact of three different intervention conditions designed to increase use of the Medicaid smoking cessation pharmacotherapy benefit and promote smoking cessation among Medicaid clients.


METHODS
In 2002, 608 current smokers receiving Medicaid benefits were recruited from the reception areas at the Department of Social Services in Erie County, New York, USA. Participants were randomized to one of three interventions: Minimal (verbal information on the Medicaid pharmacotherapy benefit), Self Help (verbal information plus self-help information materials), or Case Management (verbal information, self-help information, plus case management assistance to facilitate access to the pharmacotherapy benefit). Outcomes included (a) use of a stop-smoking medication during the three month follow-up period, (b) self-reported 7-day point prevalence abstinence at three months and (c) bioverified non-smoking status at three months (bio-chemically validated by expired Carbon Monoxide (CO) < or =8 ppm).


RESULTS
14.6% reported using a stop-smoking medication and staying off cigarettes for 24 h, 4.6% self-reported being smoke-free at three months, and 1.8% were bioverified as smoke-free. There were no differences by intervention group for these outcomes.


CONCLUSIONS
An intensive intervention designed to promote pharmacotherapy use and smoking cessation among Medicaid smokers was no more effective than less intensive interventions.
Murphy
Jill M
JM
Health Department, SUNY College at Cortland, 101 Moffett Center, PO Box 2000, Cortland, NY 13045, USA. murphyj@cortland.edu
Mahoney
Martin C
MC
Cummings
K Michael
KM
Hyland
Andrew J
AJ
Lawvere
Silvana
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009538:Nicotine / Q000037:antagonists & inhibitors*; D016017:Odds Ratio; D010349:Patient Compliance; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution; D016540:Smoking Cessation / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States
D004364:Pharmaceutical Preparations; D009538:Nicotine