Mobile Contingency Management for Concurrent Abstinence From Alcohol and Smoking

• Sponsor: Duke University (Other)
• Overall Status: Completed
• CT.gov ID: NCT02995915
• Collaborator: (none)
• Enrollment: 45
• Location: 1
• Arms: 2
• Duration (Months): 40
• Patients Per Site Per Month: 1.1

Study Details

Study Description

Brief Summary

Alcohol misuse and smoking constitute two of the three leading preventable causes of death in the United States. The purpose of this research study is to develop an intervention designed to help people stop drinking alcohol and stop smoking at the same time.

Condition or Disease	Intervention/Treatment	Phase
Smoking Cessation; Alcohol Drinking	Other: Nicotine Replacement Therapy; Drug: Bupropion; Behavioral: Cognitive Behavioral Treatment; Behavioral: Mobile Contingency Management; Behavioral: Mobile Monitoring	Phase 4

Detailed Description

Alcohol misuse and smoking constitute two of the three leading preventable causes of death in the United States. Reluctance to treat tobacco dependence among those with AUD is misguided as recent research suggests smoking cessation treatment can be effective, does not increase risk of relapse to alcohol, and may even improve rates of sobriety. There is strong evidence for the short-term efficacy for alcohol misuse and smoking of contingency management (CM). It is an intensive behavioral therapy that provides incentives (vouchers, money) to individuals misusing substances contingent upon objective evidence from drug use. Implementation of CM has been limited because of the need to verify abstinence multiple times daily using clinic based monitoring. The investigators recently developed a smart-phone application which allows a patient to video themselves several times daily while using a small CO monitor and to transmit the data to a secure server which has made the use of CM for outpatient smoking cessation portable and feasible. This mobile CM (mCM) approach paired with cognitive-behavioral counseling and pharmacological smoking cessation aids has been effective in reducing smoking.

Thus, the purpose of this project is to develop a combined alcohol and smoking mCM intervention. The intervention will be developed in two successive cohorts of five participants, who will provide information on treatment acceptability and feasibility. A third cohort of participants (n=45) will participate in a randomized clinical trials to further examine feasibility and efficacy. The long term goal is to develop mCM procedures that will be used as part of a multi-component intervention to concurrently and effectively treat both alcohol misuse and smoking. As part of this project, the investigators will develop a multi-component telehealth alcohol and smoking mCM intervention. It will include mCM, cognitive-behavioral phone counseling, and standard smoking cessation pharmacotherapy. The work proposed in these aims will provide the first step toward implementation of an innovative approach that builds upon the power of mHealth technology to reduce the prevalence of both alcohol misuse and smoking.

Study Design

• Study Type: Interventional
• Actual Enrollment: 45 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Mobile Contingency Management for Concurrent Abstinence From Alcohol and Smoking
• Study Start Date: Nov 1, 2016
• Actual Primary Completion Date: Mar 2, 2020
• Actual Study Completion Date: Mar 2, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Tele-health Mobile Contingency Management Intervention This arm includes a proactive tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, a tele-medicine clinic for access to smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM).	Other: Nicotine Replacement Therapy; Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or nicotine lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings; Other Names: nicotine gum, patch, inhaler, and/or lozenge ; Drug: Bupropion; All participants who are medically eligible will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up.; Other Names: Zyban ; Behavioral: Cognitive Behavioral Treatment; Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation.; Other Names: CBT ; Behavioral: Mobile Contingency Management; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.; Other Names: mobile CM, mCM
Active Comparator: Tele-health for Alcohol and Smoking Cessation This arm includes a proactive tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and tele-medicine clinic for access to smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants will receive monetary compensation for each assessment, regardless of abstinence.	Other: Nicotine Replacement Therapy; Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or nicotine lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings; Other Names: nicotine gum, patch, inhaler, and/or lozenge ; Drug: Bupropion; All participants who are medically eligible will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up.; Other Names: Zyban ; Behavioral: Cognitive Behavioral Treatment; Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation.; Other Names: CBT ; Behavioral: Mobile Monitoring; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.

Outcome Measures

Primary Outcome Measures

1. Number of Participants Who Self-report Prolonged Abstinence From Smoking [6 month follow-up]

   Participants will be asked to report on smoking since two weeks past quit date

2. Number of Participants Whose Prolonged Abstinence From Smoking is Bio-verified [6 month follow-up]

   Self-reported prolonged abstinence (primary outcome) will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.

3. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use [6 month follow-up]

   Participants will be asked to report on alcohol use since two weeks past quit date

4. Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified [6 month follow-up]

   Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

5. Number of Participants Who Self-report Prolonged Dual Abstinence From Both Smoking and Alcohol [6 month follow-up]

   Participants will be asked to report on smoking and alcohol use since two weeks past quit date

6. Number of Participants Whose Prolonged Dual Abstinence From Alcohol and Smoking is Bio-verified [6 month follow-up]

   Self-reported prolonged abstinence from smoking will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

Secondary Outcome Measures

1. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking [6 month follow-up]

   7-day point prevalence abstinence is defined as no smoking in the prior 7 days.

2. Number of Participants Who Report 30 Day Point Prevalence Abstinence From Smoking [6 month follow-up]

   30-day point prevalence abstinence is defined as no smoking in the prior 30 days

3. Change in the Proportion of Days in Which Consumed Alcohol Compared to Pre-quit Use [6 month follow-up]

   Participants will self-report number of days drank alcohol in the past 30 days and this will be compared to self-reported number of days drank alcohol in 30 days prior to quit.

4. Change in the Number of Standard Alcoholic Beverages Consumed Per Week Compared to Pre-quit Use [6 month follow-up]

   Participants will self-report number of alcoholic beverages consumed in past 7 days and this will be compared to self-reported number of alcoholic beverages consumed in 7 days prior to quit.

5. Change in the Number of Heavy Drinking Episodes Compared to Pre-quit Use [6 month follow-up]

   Participants will self-report number of heavy drinking episodes in the past 30 days and this will be compared to self-reported number of heavy drinking episodes in 30 days prior to quit.

6. Number of Participants Who Are Able to Achieve Recommended Drinking Limits (i.e., Less Than or Equal to 14 Drinks Per Week and Fewer Than 5 Drinks Per Day for Men; Less Than or Equal to 7 Days Per Week and Less Than 4 Drinks Per Day for Women) [6 month follow-up]

   Participants will be asked to report on alcohol use in past week

7. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use [6 week follow-up (i.e., end of treatment visit)]

   Participants will be asked to report on alcohol use since two weeks past quit date

8. Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified [6 week follow-up (i.e., end of treatment visit)]

   Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.

9. Change in Number of Average Cigarettes Smoked Per Day [6 month follow-up]

   Participants will self-report average number of cigarettes smoked in the past week and this will be compared to self-reported number of smoked in the week prior to quit.

10. Change in the Proportion of Days in Which Smoked Compared to Pre-quit Use [6 month follow-up]

    Participants will self-report number of days smoked in the past 30 days and this will be compared to self-reported number of days smoked 30 days prior to quit.

11. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking [6 week follow-up (i.e., end of treatment visit)]

    Participants will be asked to report on smoking since two weeks past quit date

12. Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking [8 week follow-up (i.e., Session 7, end of monitoring visit)]

    Participants will be asked to report on smoking since two weeks past quit date

13. Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use [8 week follow-up (i.e., Session 7, end of monitoring visit)]

    Participants will be asked to report on alcohol use since two weeks past quit

14. Number of Participants Who Self-report Prolonged Abstinence From Smoking [6 week follow-up (i.e., end of treatment visit)]

    Participants will be asked to report on alcohol use since two weeks past quit

15. Number of Participants Who Self-report Prolonged Abstinence From Smoking [8 week follow-up (i.e., Session 7, end of monitoring visit)]

    Participants will be asked to report on alcohol use since two weeks past quit

16. Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking [6 week follow-up (i.e., end of treatment visit)]

    Participants will be asked to report on smoking since two weeks past quit date

17. Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking [8 week follow-up (i.e., Session 7, end of monitoring visit)]

    Participants will be asked to report on smoking since two weeks past quit date

18. Number of Smoking Quit Attempts [6 week follow-up (i.e., end of treatment visit)]

    Participants will be asked to report the number of quit attempts made since quit date

19. Number of Smoking Quit Attempts [8 week follow-up (i.e., Session 7, end of monitoring visit)]

    Participants will be asked to report the number of quit attempts made since quit date

20. Number of Smoking Quit Attempts [6-month follow-up]

    Participants will be asked to report the number of quit attempts made since quit date

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 80 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• currently meet criteria for DSM-5 mild to moderate alcohol use disorder (meeting 2-5 criteria for AUD)

• have been engaging in hazardous drinking over the past month, defined as either exceeding a mean of 14 standard drinks/wk for men, 7 drinks/wk for women; or by consuming >5 on at least one occasion in the last month for men, >4 drinks on at least one occasion in the last month for women

• currently smoke >10 cigarettes a day, and have smoked for at least one year

• can speak and write fluent conversational English

• are willing to make an attempt to quit both alcohol and smoking

Exclusion Criteria:

• are expected to have unstable medication regimen during the study

• are currently receiving non-study behavioral treatment for alcohol use disorder or smoking

• have severe alcohol use disorder (meeting >6 criteria for AUD or having alcohol withdrawal symptom criterion)

• have AUD that is in early remission, with no symptoms evident over the past month

• have experienced myocardial infarction in past 6 months

• contraindication to nicotine replacement therapy with no medical clearance to participate in the study

• use other forms of nicotine such as cigars, pipes, or chewing tobacco

• are currently pregnant

• have a primary psychotic disorder or current manic episode

• have had substance use disorder (other than alcohol or nicotine) in the preceding 3 months

• are currently imprisoned or in psychiatric hospitalization

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Duke University Medical Center	Durham	North Carolina	United States	27706

Sponsors and Collaborators

• Duke University

Investigators

• Principal Investigator: Eric A. Dedert, Ph.D., Study Principal Investigator

Study Documents (Full-Text)

• Study Protocol and Statistical Analysis Plan - Mar 18, 2019
• Informed Consent Form - Sep 11, 2018

More Information

Publications

None provided.

• Responsible Party: Duke University
• ClinicalTrials.gov Identifier: NCT02995915
• Other Study ID Numbers: Pro00062101
• First Posted: Dec 19, 2016
• Last Update Posted: Apr 28, 2021
• Last Verified: Apr 1, 2021

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Additional relevant MeSH terms: Alcohol Drinking; Bupropion; Nicotine

Study Results

Participant Flow

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Period Title: Overall Study
STARTED	30	15
COMPLETED	30	15
NOT COMPLETED	0	0

Baseline Characteristics

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation	Total
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.	Total of all reporting groups
Overall Participants	30	15	45
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	42.77 (11.39)	42.67 (11.46)	42.73 (11.41)
Sex: Female, Male (Count of Participants)
Female	6 20%	3 20%	9 20%
Male	24 80%	12 80%	36 80%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino	0 0%	0 0%	0 0%
Not Hispanic or Latino	30 100%	15 100%	45 100%
Unknown or Not Reported	0 0%	0 0%	0 0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native	1 3.3%	1 6.7%	2 4.4%
Asian	0 0%	0 0%	0 0%
Native Hawaiian or Other Pacific Islander	0 0%	0 0%	0 0%
Black or African American	21 70%	11 73.3%	32 71.1%
White	7 23.3%	2 13.3%	9 20%
More than one race	1 3.3%	1 6.7%	2 4.4%
Unknown or Not Reported	0 0%	0 0%	0 0%
Region of Enrollment (Count of Participants)
United States	30 100%	15 100%	45 100%

Outcome Measures

1. Primary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Smoking
Description	Participants will be asked to report on smoking since two weeks past quit date
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	3 10%	0 0%

2. Primary Outcome

Title	Number of Participants Whose Prolonged Abstinence From Smoking is Bio-verified
Description	Self-reported prolonged abstinence (primary outcome) will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	2 6.7%	0 0%

3. Primary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use
Description	Participants will be asked to report on alcohol use since two weeks past quit date
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	4 13.3%	0 0%

4. Primary Outcome

Title	Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified
Description	Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

This subset of participants self-reported prolonged abstinence from alcohol.

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	4	0
Count of Participants [Participants]	4 13.3%	0 0%

5. Primary Outcome

Title	Number of Participants Who Self-report Prolonged Dual Abstinence From Both Smoking and Alcohol
Description	Participants will be asked to report on smoking and alcohol use since two weeks past quit date
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	1 3.3%	0 0%

6. Primary Outcome

Title	Number of Participants Whose Prolonged Dual Abstinence From Alcohol and Smoking is Bio-verified
Description	Self-reported prolonged abstinence from smoking will be verified by cotinine assay. Saliva samples will be collected from participants who self-report prolonged abstinence.Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

This subset of participants self-reported dual abstinence from alcohol use and smoking.

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	1	0
Count of Participants [Participants]	1 3.3%	0 0%

7. Secondary Outcome

Title	Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking
Description	7-day point prevalence abstinence is defined as no smoking in the prior 7 days.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	6 20%	2 13.3%

8. Secondary Outcome

Title	Number of Participants Who Report 30 Day Point Prevalence Abstinence From Smoking
Description	30-day point prevalence abstinence is defined as no smoking in the prior 30 days
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	5 16.7%	1 6.7%

9. Secondary Outcome

Title	Change in the Proportion of Days in Which Consumed Alcohol Compared to Pre-quit Use
Description	Participants will self-report number of days drank alcohol in the past 30 days and this will be compared to self-reported number of days drank alcohol in 30 days prior to quit.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [drinking days per month]	-9.67 (9.68)	-10.3 (10.69)

10. Secondary Outcome

Title	Change in the Number of Standard Alcoholic Beverages Consumed Per Week Compared to Pre-quit Use
Description	Participants will self-report number of alcoholic beverages consumed in past 7 days and this will be compared to self-reported number of alcoholic beverages consumed in 7 days prior to quit.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [drinks per week]	-7.53 (17.54)	-13.9 (17.72)

11. Secondary Outcome

Title	Change in the Number of Heavy Drinking Episodes Compared to Pre-quit Use
Description	Participants will self-report number of heavy drinking episodes in the past 30 days and this will be compared to self-reported number of heavy drinking episodes in 30 days prior to quit.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [heavy drinking episodes]	-9.22 (10.22)	-11.00 (9.61)

12. Secondary Outcome

Title	Number of Participants Who Are Able to Achieve Recommended Drinking Limits (i.e., Less Than or Equal to 14 Drinks Per Week and Fewer Than 5 Drinks Per Day for Men; Less Than or Equal to 7 Days Per Week and Less Than 4 Drinks Per Day for Women)
Description	Participants will be asked to report on alcohol use in past week
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	16 53.3%	8 53.3%

13. Secondary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use
Description	Participants will be asked to report on alcohol use since two weeks past quit date
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	14 46.7%	3 20%

14. Secondary Outcome

Title	Number of Participants Whose Prolonged Abstinence From Alcohol is Bio-verified
Description	Self-reported prolonged abstinence will be verified by breathalyzer. Breathalyzer data will be collected from participants who self-report prolonged abstinence.
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	13 43.3%	1 6.7%

15. Secondary Outcome

Title	Change in Number of Average Cigarettes Smoked Per Day
Description	Participants will self-report average number of cigarettes smoked in the past week and this will be compared to self-reported number of smoked in the week prior to quit.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [cigarettes per day]	-8.56 (7.45)	-5.30 (6.50)

16. Secondary Outcome

Title	Change in the Proportion of Days in Which Smoked Compared to Pre-quit Use
Description	Participants will self-report number of days smoked in the past 30 days and this will be compared to self-reported number of days smoked 30 days prior to quit.
Time Frame	6 month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [days]	-9.22 (10.98)	-4.70 (11.50)

17. Secondary Outcome

Title	Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking
Description	Participants will be asked to report on smoking since two weeks past quit date
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	12 40%	7 46.7%

18. Secondary Outcome

Title	Number of Participants Who Self-report 7 Day Point Prevalence Abstinence From Smoking
Description	Participants will be asked to report on smoking since two weeks past quit date
Time Frame	8 week follow-up (i.e., Session 7, end of monitoring visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	13 43.3%	9 60%

19. Secondary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Alcohol Use
Description	Participants will be asked to report on alcohol use since two weeks past quit
Time Frame	8 week follow-up (i.e., Session 7, end of monitoring visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	13 43.3%	1 6.7%

20. Secondary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Smoking
Description	Participants will be asked to report on alcohol use since two weeks past quit
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	11 36.7%	0 0%

21. Secondary Outcome

Title	Number of Participants Who Self-report Prolonged Abstinence From Smoking
Description	Participants will be asked to report on alcohol use since two weeks past quit
Time Frame	8 week follow-up (i.e., Session 7, end of monitoring visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	7 23.3%	0 0%

22. Secondary Outcome

Title	Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking
Description	Participants will be asked to report on smoking since two weeks past quit date
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	2 6.7%	2 13.3%

23. Secondary Outcome

Title	Number of Participants Who Self-report 30 Day Point Prevalence Abstinence From Smoking
Description	Participants will be asked to report on smoking since two weeks past quit date
Time Frame	8 week follow-up (i.e., Session 7, end of monitoring visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Count of Participants [Participants]	5 16.7%	2 13.3%

24. Secondary Outcome

Title	Number of Smoking Quit Attempts
Description	Participants will be asked to report the number of quit attempts made since quit date
Time Frame	6 week follow-up (i.e., end of treatment visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [smoking quit attempts]	2.25 (6.58)	0.86 (0.38)

25. Secondary Outcome

Title	Number of Smoking Quit Attempts
Description	Participants will be asked to report the number of quit attempts made since quit date
Time Frame	8 week follow-up (i.e., Session 7, end of monitoring visit)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [smoking quit attempts]	0.44 (1.03)	4.11 (9.84)

26. Secondary Outcome

Title	Number of Smoking Quit Attempts
Description	Participants will be asked to report the number of quit attempts made since quit date
Time Frame	6-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Tele-health Mobile Contingency Management Intervention	Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.	This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
Measure Participants	30	15
Mean (Standard Deviation) [smoking quit attempts]	2.29 (7.17)	1.00 (1.64)

Adverse Events

Time Frame	Adverse events were collected for approximately seven months, from informed consent signature to the 6-month follow-up visit, which occurred six months after the substance quit date (session 4).
Arm/Group Title	Tele-health Mobile Contingency Management Intervention		Tele-health for Alcohol and Smoking Cessation
Arm/Group Description	This arm includes a tele-health intervention that combines evidence-based telephone cognitive behavioral treatment for alcohol and smoking cessation, smoking cessation pharmacotherapy (including nicotine replacement therapy and bupropion), and mobile contingency management treatment administered via a smart-phone based application (mobile CM). Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: All medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Contingency Management: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence, and breathalyzer to confirm abstinence from alcohol. Participants are provided monetary reward for videos that suggest smoking abstinence and alcohol abstinence.		This arm includes a tele-health intervention that will provide controls for therapist, medication, time and attention effects. The tele-health intervention provides the same evidence-based telephone CBT for alcohol and smoking cessation, and smoking cessation pharmacotherapy as in the mCM intervention, but does not include mCM. Instead, participants receive monetary compensation for each assessment, regardless of abstinence. Nicotine Replacement Therapy: Participants will be prescribed NRT patch and one nicotine rescue method (e.g., nicotine gum, lozenge, inhaler) for use during the post-quit phase of the study. Participants will be given the choice between nicotine gum or lozenge, and will be instructed to use the rescue method as needed to reduce cigarette cravings Bupropion: medically eligible participants will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up. Cognitive Behavioral Treatment: Participants will receive 4 60-minute sessions of CBT telephone counseling for alcohol and smoking cessation. Mobile Monitoring: Participants will be asked to provide video recordings of themselves taking carbon monoxide readings and breathalyzer. Participants are asked to upload these videos to the study's secured server, and are provided monetary reward for providing the video recordings, regardless of abstinence.
All Cause Mortality
	Tele-health Mobile Contingency Management Intervention		Tele-health for Alcohol and Smoking Cessation
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/30 (0%)		0/15 (0%)
Serious Adverse Events
	Tele-health Mobile Contingency Management Intervention		Tele-health for Alcohol and Smoking Cessation
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	2/30 (6.7%)		0/15 (0%)
Gastrointestinal disorders
Hospitalization secondary to burned esophagus	1/30 (3.3%)	1	0/15 (0%)	0
General disorders
Hospitalization secondary to flu	1/30 (3.3%)	1	0/15 (0%)	0
Other (Not Including Serious) Adverse Events
	Tele-health Mobile Contingency Management Intervention		Tele-health for Alcohol and Smoking Cessation
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	6/30 (20%)		0/15 (0%)
Gastrointestinal disorders
Nausea/diarrhea	2/30 (6.7%)	3	0/15 (0%)	0
Psychiatric disorders
Increased stress	1/30 (3.3%)	2	0/15 (0%)	0
Threat of domestic violence	1/30 (3.3%)	1	0/15 (0%)	0
Increase in depressed mood	1/30 (3.3%)	1	0/15 (0%)	0
Skin and subcutaneous tissue disorders
Skin irritation	1/30 (3.3%)	1	0/15 (0%)	0
Surgical and medical procedures
Dental surgery	1/30 (3.3%)	1	0/15 (0%)	0

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.