Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking
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Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial Elena Bilevicius1†, Alanna Single1†, Chris Baumgartner2, Van Bui1, Tyler Kempe1, Michael P. Schaub2, Sherry H. Stewart3, James MacKillop4, David C. Hodgins5, Jeffrey D. Wardell6, Roisin O’Connor7, Jennifer Read8, Heather Hadjistavropoulos9, Christopher Sundstrom9 and Matthew T. Keough10*
Abstract Background: Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. Methods: The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. Discussion: The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a costeffective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. (Continued on next page)
* Correspondence: [email protected] Elena Bilevicius and Alanna Single shared joint first-authorship. 10 Department of Psychology, York University, 4700 Keele St, North York, ON M3J 1P3, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative C
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