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Grant Details

Grant Number: 5R35CA197573-06 Interpret this number
Primary Investigator: Fiore, Michael
Organization: University Of Wisconsin-Madison
Project Title: Transforming the Treatment of Tobacco Use in Health Care: Seizing the Potential of the Electronic Health Record to Deliver Comprehensive Chronic Care Treatment for Smoking
Fiscal Year: 2020


 DESCRIPTION (provided by applicant): Smoking maintains its grip on over 40 million Americans, resulting in devastating illness, grievous economic loss, and tragic death for over 480,000 Americans each year. Tobacco use is the leading preventable cause of cancer, directly responsible for 1/3 of cancer deaths. This profound toll would be dramatically reduced if we substantially boosted rates of cessation among the 70% of smokers making healthcare visits each year. Despite multiple effective smoking treatments, and despite powerful health information technologies such as the electronic health record (EHR), far too few smokers get effective treatment during their healthcare visits. This is largely due to a failure of translatioal science; much translation of treatment research occurs by guesswork and hunch. This R35 Outstanding Investigator proposal will address the great need for translation of tobacco science via a unique set of real-world partners: a Wisconsin health system that will serve as a "primary care laboratory," the world's leading EHR vendor, and a nationally renowned tobacco cessation research team led by the PI, Michael Fiore. These partners propose to: 1) develop and apply highly efficient and novel research methods to advance methodologically principled intervention translation, 2) design and test a highly efficient EHR-based treatment support system that organizes tobacco cessation treatment and fosters its dissemination, and 3) increase treatment effectiveness by delivering truly comprehensive chronic care smoking treatment to primary care patients. Thus, EHR changes and groundbreaking research methods will be used to re-engineer healthcare delivery systems to efficiently and seamlessly organize and deliver state-of-the-art treatment to the great majority of the nearly 30 million smokers visiting primary care settings each year. The smoking treatment and its support system will be designed for ready dissemination across health systems and diverse EHR platforms. The translational research methods should benefit any attempt to translate preventive health interventions. The proposed Principal Investigator has a 26-year track record of reducing tobacco use and its resulting harms. His experiences as a practicing physician, tobacco control scientist, and designer of national smoking policies, reflect enormous potential to fulfill the goals of the R35 mechanism - to revolutionize the delivery of tobacco use treatment so as to prevent literally millions of cance deaths.


Cost-effectiveness of stop smoking incentives for medicaid-enrolled pregnant women.
Authors: Mundt M.P. , Fiore M.C. , Piper M.E. , Adsit R.T. , Kobinsky K.H. , Alaniz K.M. , Baker T.B. .
Source: Preventive medicine, 2021 Dec; 153, p. 106777.
EPub date: 2021-08-25.
PMID: 34450189
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Closed-Loop Electronic Referral From Primary Care Clinics to a State Tobacco Cessation Quitline: Effects Using Real-World Implementation Training.
Authors: Baker T.B. , Berg K.M. , Adsit R.T. , Skora A.D. , Swedlund M.P. , Zehner M.E. , McCarthy D.E. , Glasgow R.E. , Fiore M.C. .
Source: American journal of preventive medicine, 2021 03; 60(3 Suppl 2), p. S113-S122.
PMID: 33663698
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Ten Million Calls and Counting: Progress and Promise of Tobacco Quitlines in the U.S.
Authors: Fiore M.C. , Baker T.B. .
Source: American journal of preventive medicine, 2021 03; 60(3 Suppl 2), p. S103-S106.
PMID: 33663696
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Care-paradigm shift promoting smoking cessation treatment among cancer center patients via a low-burden strategy, Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment.
Authors: Ramsey A.T. , Chiu A. , Baker T. , Smock N. , Chen J. , Lester T. , Jorenby D.E. , Colditz G.A. , Bierut L.J. , Chen L.S. .
Source: Translational behavioral medicine, 2020-12-31; 10(6), p. 1504-1514.
PMID: 31313808
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Closed-loop electronic referral to SmokefreeTXT for smoking cessation support: a demonstration project in outpatient care.
Authors: McCarthy D.E. , Adsit R.T. , Zehner M.E. , Mahr T.A. , Skora A.D. , Kim N. , Baker T.B. , Fiore M.C. .
Source: Translational behavioral medicine, 2020-12-31; 10(6), p. 1472-1480.
PMID: 31173140
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Financial incentives to Medicaid smokers for engaging tobacco quit line treatment: maximising return on investment.
Authors: Mundt M.P. , Baker T.B. , Piper M.E. , Smith S.S. , Fraser D.L. , Fiore M.C. .
Source: Tobacco control, 2020 05; 29(3), p. 320-325.
EPub date: 2019-05-30.
PMID: 31147478
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Low Burden Strategies Are Needed to Reduce Smoking in Rural Healthcare Settings: A Lesson from Cancer Clinics.
Authors: Ramsey A.T. , Baker T.B. , Pham G. , Stoneking F. , Smock N. , Colditz G.A. , James A.S. , Liu J. , Bierut L.J. , Chen L.S. .
Source: International journal of environmental research and public health, 2020-03-06; 17(5), .
EPub date: 2020-03-06.
PMID: 32155775
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Prevalence of Tobacco Use Among Rural-Dwelling Individuals Who Inject Drugs.
Authors: Akhtar W.Z. , Mundt M.P. , Koepke R. , Krechel S. , Fiore M.C. , Seal D.W. , Westergaard R.P. .
Source: JAMA network open, 2020-03-02; 3(3), p. e200493.
EPub date: 2020-03-02.
PMID: 32154885
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An electronic health record-based interoperable eReferral system to enhance smoking Quitline treatment in primary care.
Authors: Fiore M. , Adsit R. , Zehner M. , McCarthy D. , Lundsten S. , Hartlaub P. , Mahr T. , Gorrilla A. , Skora A. , Baker T. .
Source: Journal of the American Medical Informatics Association : JAMIA, 2019-08-01; 26(8-9), p. 778-786.
PMID: 31089727
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Addressing a Core Gap in Cancer Care - The NCI Moonshot Program to Help Oncology Patients Stop Smoking.
Authors: Croyle R.T. , Morgan G.D. , Fiore M.C. .
Source: The New England journal of medicine, 2019-02-07; 380(6), p. 512-515.
EPub date: 2019-01-02.
PMID: 30601710
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Paying Low-Income Smokers to Quit? The Cost-Effectiveness of Incentivizing Tobacco Quit Line Engagement for Medicaid Recipients Who Smoke.
Authors: Mundt M.P. , Baker T.B. , Fraser D.L. , Smith S.S. , Piper M.E. , Fiore M.C. .
Source: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2019 02; 22(2), p. 177-184.
EPub date: 2018-09-20.
PMID: 30711062
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Triple Smoking Cessation Therapy with Varenicline, Nicotine Patch and Nicotine Lozenge: A Pilot Study to Assess Tolerability, Satisfaction, and End-of-Treatment Quit Rates.
Authors: Berg K.M. , Jorenby D.E. , Baker T.B. , Fiore M.C. .
Source: Journal of smoking cessation, 2018 Sep; 13(3), p. 145-153.
EPub date: 2017-09-25.
PMID: 30524509
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Helping Smokers with Severe Mental Illness Who Do Not Want to Quit.
Authors: Christiansen B.A. , Carbin J. , TerBeek E. , Fiore M.C. .
Source: Substance use & misuse, 2018-05-12; 53(6), p. 949-962.
EPub date: 2017-11-21.
PMID: 29161166
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A Randomized Trial of Incentives for Smoking Treatment in Medicaid Members.
Authors: Fraser D.L. , Fiore M.C. , Kobinsky K. , Adsit R. , Smith S.S. , Johnson M.L. , Baker T.B. .
Source: American journal of preventive medicine, 2017 Dec; 53(6), p. 754-763.
EPub date: 2017-11-02.
PMID: 29079405
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The 2016 Ferno Award Address: Three Things.
Authors: Baker T.B. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2017-08-01; 19(8), p. 891-900.
PMID: 28201626
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Implementing Clinical Research Using Factorial Designs: A Primer.
Authors: Baker T.B. , Smith S.S. , Bolt D.M. , Loh W.Y. , Mermelstein R. , Fiore M.C. , Piper M.E. , Collins L.M. .
Source: Behavior therapy, 2017 07; 48(4), p. 567-580.
EPub date: 2017-01-07.
PMID: 28577591
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Longitudinal Impact of Smoking and Smoking Cessation on Inflammatory Markers of Cardiovascular Disease Risk.
Authors: King C.C. , Piper M.E. , Gepner A.D. , Fiore M.C. , Baker T.B. , Stein J.H. .
Source: Arteriosclerosis, thrombosis, and vascular biology, 2017 02; 37(2), p. 374-379.
EPub date: 2016-12-08.
PMID: 27932354
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Exploring Issues of Comorbid Conditions in People Who Smoke.
Authors: Rojewski A.M. , Baldassarri S. , Cooperman N.A. , Gritz E.R. , Leone F.T. , Piper M.E. , Toll B.A. , Warren G.W. , Comorbidities Workgroup of the Society for Research on Nicotine and Tobacco (SRNT) Treatment Network .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2016 08; 18(8), p. 1684-96.
EPub date: 2016-01-17.
PMID: 26783291
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A Survey of Baseline Tobacco Cessation Clinical Practices and Receptivity to Academic Detailing.
Authors: Adsit R. , Wisinski K. , Mattison R. , Bailey H. , Fiore M. .
Source: WMJ : official publication of the State Medical Society of Wisconsin, 2016 Jun; 115(3), p. 143-6.
PMID: 27443091
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Will Hospitals Finally "Do the Right Thing"? Providing Evidence-Based Tobacco Dependence Treatments to Hospitalized Patients Who Smoke.
Authors: Fiore M.C. , Adsit R. .
Source: Joint Commission journal on quality and patient safety, 2016 May; 42(5), p. 207-8.
PMID: 27066923
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Don't Wait for COPD to Treat Tobacco Use.
Authors: Fiore M.C. , Jorenby D.E. , Baker T.B. .
Source: Chest, 2016 Mar; 149(3), p. 617-8.
PMID: 26965965
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Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation at 26 Weeks: A Randomized Clinical Trial.
Authors: Baker T.B. , Piper M.E. , Stein J.H. , Smith S.S. , Bolt D.M. , Fraser D.L. , Fiore M.C. .
Source: JAMA, 2016-01-26; 315(4), p. 371-9.
PMID: 26813210
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Enhancing the effectiveness of smoking treatment research: conceptual bases and progress.
Authors: Baker T.B. , Collins L.M. , Mermelstein R. , Piper M.E. , Schlam T.R. , Cook J.W. , Bolt D.M. , Smith S.S. , Jorenby D.E. , Fraser D. , et al. .
Source: Addiction (Abingdon, England), 2016 Jan; 111(1), p. 107-16.
EPub date: 2015-11-19.
PMID: 26581974
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Withdrawal: Expanding a Key Addiction Construct.
Authors: Piper M.E. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2015 Dec; 17(12), p. 1405-15.
EPub date: 2015-03-05.
PMID: 25744958
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Reduced-Nicotine Cigarettes--A Promising Regulatory Pathway.
Authors: Fiore M. , Baker T. .
Source: The New England journal of medicine, 2015 Oct; 373(14), p. 1289-91.
PMID: 26422720
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Defining and predicting short-term alcohol use changes during a smoking cessation attempt.
Authors: Berg K.M. , Piper M.E. , Smith S.S. , Fiore M.C. , Jorenby D.E. .
Source: Addictive behaviors, 2015 Sep; 48, p. 52-7.
EPub date: 2015-04-29.
PMID: 25997014
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Anhedonia as a component of the tobacco withdrawal syndrome.
Authors: Cook J.W. , Piper M.E. , Leventhal A.M. , Schlam T.R. , Fiore M.C. , Baker T.B. .
Source: Journal of abnormal psychology, 2015 Feb; 124(1), p. 215-25.
EPub date: 2014-11-10.
PMID: 25384069
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Rates and predictors of renewed quitting after relapse during a one-year follow-up among primary care patients.
Authors: Bold K.W. , Rasheed A.S. , McCarthy D.E. , Jackson T.C. , Fiore M.C. , Baker T.B. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2015 Feb; 49(1), p. 128-40.
PMID: 24796541
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Utilization of the Electronic Health Record to Improve Provision of Smoking Cessation Resources for Vascular Surgery Inpatients.
Authors: Smith B.K. , Adsit R.T. , Jorenby D.E. , Matsumura J.S. , Fiore M.C. .
Source: International journal of cardiovascular research, 2015; 4(5), .
EPub date: 2015-05-30.
PMID: 26566531
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