New methods for tobacco dependence treatment research.

New methods for tobacco dependence treatment research.
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烟草依赖治疗研究的新方法。

DOI:
10.1007/s12160-010-9252-y
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发表时间:
2011-04
期刊:
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
影响因子:
--
通讯作者:
Fiore MC
Fiore MC
中科院分区:
其他
文献类型:
--
作者:
Baker TB;Mermelstein R;Collins LM;Piper ME;Jorenby DE;Smith SS;Christiansen BA;Schlam TR;Cook JW;Fiore MC

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尽管在过去20年里,烟草依赖治疗取得了进展,但进展不稳定,进展缓慢。本文回顾了可能导致烟草治疗科学缺乏及时进展的普遍的方法学问题,包括:缺乏戒烟过程的动态模型或框架,低效的研究设计,以及使用的远端结果衡量标准不佳的治疗效果。然后,作者提出了一个基于阶段的戒烟框架,根据当前的戒烟理论和经验数据,将戒烟过程划分为四个离散的阶段。这些阶段包括:1)激励,2)事前,3)停止,4)维持。在这一框架内,有可能确定吸烟者在戒烟时将遇到的分阶段挑战、应对这些分阶段挑战的干预内容、这些干预措施发挥作用的机制以及与这些分阶段干预措施相联系的最佳结果衡量标准。通过使用有效的研究设计,可以更及时地开发最佳戒烟治疗方案,从而加速基于阶段的干预措施的调查。
Despite advances in tobacco dependence treatment in the past two decades, progress has been inconsistent and slow. This paper reviews pervasive methodological issues that may contribute to the lack of timely progress in tobacco treatment science including: the lack of a dynamic model or framework of the cessation process, inefficient study designs, and the use of distal outcome measures that poorly index treatment effects. The authors then present a phase-based cessation framework that partitions the cessation process into four discrete phases based on current theories of cessation and empirical data. These phases include: 1) Motivation, 2) Precessation, 3) Cessation, and 4) Maintenance. Within this framework it is possible to identify phase-specific challenges that a smoker would encounter while quitting smoking, intervention components that would address these phase-specific challenges, mechanisms via which such interventions would exert their effects and optimal outcome measures linked to these phase-specific interventions. Investigation of phase-based interventions can be accelerated by using efficient study designs that would permit more timely development of an optimal smoking cessation treatment package.
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