Quitting Smoking

Smoking is the leading preventable cause of death in the United States, and quitting is especially difficult for couples who both smoke. When both partners smoke, they are less likely to quit successfully and more likely to relapse compared to people whose partner does not smoke. Research suggests that the way romantic partners interact and support each other during a quit attempt can make a real difference - but researchers do not yet know enough about what kinds of support actually help. This study examines a concept called "communal coping," which refers to when partners treat a shared health challenge - like quitting smoking - as something they are facing together as a team rather than as separate individuals. Researchers believe that couples who approach quitting this way may have better outcomes. To study this, researchers will ask both members of dual-smoking couples to complete brief daily surveys over two weeks while making a quit attempt. These surveys will track how partners support (or discourage) each other's quitting efforts on a day-to-day basis, along with cigarette use, cravings, and stress. This will help researchers understand which relationship patterns are most helpful for quitting, and identify specific targets for future couples-based smoking cessation programs.

The goal of this clinical trial is to evaluate the effectiveness and implementation of a pharmacist-delivered MTM (medication therapy management) approach, called QuitAid, to quitting cigarette smoking in rural Appalachia. The main questions it aims to answer are: * Is QuitAid, alone or combined with other quitting tobacco treatments, effective? * What makes QuitAid easy or hard to carry out? Is it cost effective? Is it easy to maintain? Treatment: All participants will be given at least 4 weeks of the nicotine patch. Some participants will be randomized (like the flip of a coin) to receive additional treatments (listed below). These groups will be compared to each other to see which combination works best to help them quit smoking. * Smokefree TXT - a texting program that helps people quit smoking * Tobacco quitline - 4 phone sessions to help people quit smoking * 8 weeks of NRT (nicotine replacement therapy in the form of nicotine patches or nicotine patches and lozenge) medication instead of 4 weeks * QuitAid - An MTM program given by the patient's pharmacist. This is a quitting smoking coaching program * Nicotine patch AND nicotine lozenge instead of just nicotine patches