An exploratory randomized controlled trial of a novel high-school-based smoking cessation intervention for adolescent smokers using abstinence-contingent incentives and cognitive behavioral therapy
An exploratory randomized controlled trial of a novel high-school-based smoking cessation intervention for adolescent smokers using abstinence-contingent incentives and cognitive behavioral therapy
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DOI：
10.1016/j.drugalcdep.2013.03.002
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发表时间：
2013-09-01
影响因子：
4.2
通讯作者：
Carroll, Kathleen M.
中科院分区：
文献类型：
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作者：
Krishnan-Sarin, Suchitra;Cavallo, Dana A.;Carroll, Kathleen M.
背景：针对青少年吸烟者的有效戒烟干预措施很少。我们开发了一种新颖的干预措施，通过以下方式激励烟草使用行为改变：(1) 通过使用戒烟相关激励措施 (CM) 增强戒烟意愿，(2) 通过使用认知行为疗法 (CBT) 提高戒烟技能，以及 (3) 通过在高中内实施消除戒烟障碍。方法：在康涅狄格州高中进行了一项为期 4 周的探索性随机对照试验，以消除 CM 和 CBT 的独立影响和综合影响；吸烟者接受单独 CM、单独 CBT 或 CM + CBT。参与者包括 82 名寻求戒烟治疗的青少年吸烟者。主要结局是 7 天治疗结束 (EOT) 点的戒断率 (PP)，通过尿可替宁水平确认的自我报告确定。次要结局包括治疗和随访期间的一天 EOT PP 戒烟和吸烟情况。 结果：在开始治疗的参与者 (n = 72) 中，观察到 7 天 EOT-PP 戒烟的组间差异 (chi(2) = 10.48，p < 0.01），与 CBT (0%) 相比，CM + CBT (36.7%) 和 CM (36.3%) 条件下的戒烟率较高。一天 EOT-PP 戒断表现出类似的效果（chi(2) = 10.39，p < 0.01；CM+CBT：43%，CM：43%，CBT：4.3%）。生存分析表明治疗期间第一次吸烟的时间存在差异（chi(2)=8.73，p=0.003；CBT：第3天，CM：第9天，CM + CBT：第20天）。在一个月和三个月的随访中，虽然没有观察到差异，但单独服用 CM 组的卷烟使用量增长最慢。结论：高中基于激励的戒烟干预措施在青少年吸烟者中产生了较高的短期戒烟率；添加认知行为疗法似乎并没有进一步改善结果。 (C) 2013 Elsevier Ireland Ltd. 保留所有权利。
Background: There are few effective smoking cessation interventions for adolescent smokers. We developed a novel intervention to motivate tobacco use behavior change by (1) enhancing desire to quit through the use of abstinence-contingent incentives (CM), (2) increasing cessation skills through the use of cognitive behavioral therapy (CBT), and (3) removing cessation barriers through delivery within high schools.Methods: An exploratory four-week, randomized controlled trial was conducted in Connecticut high schools to dismantle the independent and combined effects of CM and CBT; smokers received CM alone, CBT alone, or CM + CBT. Participants included 82 adolescent smokers seeking smoking cessation treatment. The primary outcome was seven-day end-of-treatment (EOT) point prevalence (PP) abstinence, determined using self-reports confirmed using urine cotinine levels. Secondary outcomes included one-day EOT PP abstinence and cigarette use during treatment and follow up.Results: Among participants who initiated treatment (n = 72), group differences in seven-day EOT-PP abstinence were observed (chi(2) = 10.48, p < 0.01) with higher abstinence in the CM + CBT (36.7%) and CM (36.3%) conditions when compared with CBT (0%). One-day EOT-PP abstinence evidenced similar effects (chi(2) = 10.39, p < 0.01; CM+CBT: 43%, CM: 43%, CBT: 4.3%). Survival analyses indicated differences in time to first cigarette during treatment (chi(2)=8.73,p = 0.003; CBT: Day 3, CM: Day 9, CM + CBT: Day 20). At one- and three-month follow ups, while no differences were observed, the CM alone group had the slowest increase in cigarette use.Conclusions: High-school, incentive-based smoking cessation interventions produce high rates of short-term abstinence among adolescent smokers; adding cognitive behavioral therapy does not appear to further enhance outcomes. (C) 2013 Elsevier Ireland Ltd. All rights reserved.