Quit now? Quit soon? Quit when you're ready? Insights about target quit dates for smoking cessation from an online quit date tool.
Quit now? Quit soon? Quit when you're ready? Insights about target quit dates for smoking cessation from an online quit date tool.
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DOI：
10.2196/jmir.3086
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发表时间：
2014-02-17
影响因子：
7.4
通讯作者：
Graham AL
中科院分区：
文献类型：
--
作者：
Cobb CO;Niaura RS;Donaldson EA;Graham AL
设定目标戒烟日期（TQD）通常是戒烟治疗的一个重要组成部分，但关于最佳时机（即自发戒烟与延迟准备）仍然存在模糊性。我们在iQUITT研究（一项互联网和电话戒烟治疗的随机试验）的次要分析中检查了四个关于TQD时间和吸烟结局的问题：（1）使用在线交互式戒烟日期工具设置的TQD的特征是什么？，(2)使用戒烟工具的人有什么特点，他们与不使用的人有什么不同？(3)基于TQD时间的吸烟者特征、治疗利用和戒烟结果是否存在差异？，和（4）维持初始TQD是否预示戒断，或者TQD的改变是否导致停止？共有825名成年吸烟者被随机分配到加强互联网或加强互联网加电话咨询。TQD的潜伏期（天）计算为初始TQD和增强互联网注册之间的日期差异;前瞻性TQD设置者分为4个潜伏期组（0、1-14、15-28、29+天）。在前瞻性TQD组之间检查基线变量、网站利用率和3个月戒烟结果。戒烟的愿望和信心，TQD的数量和网站登录作为预测30天的点患病率禁欲（ppa）在3个月（仅响应者分析）。分类和回归树（CART）分析探讨了基线变量，网站利用率和TQD延迟之间的相互作用，作为30天ppa的预测因子。使用戒烟日期工具的人和那些没有使用的人之间几乎没有基线差异。前瞻性TQD设定如下：登记日为17.1%（73/427），1-14天为37.7%（161/427），15-28天为18.5%（79/427），29天以上为26.7%（114/427）。在2周内有TQD的参与者有更高的基线自我效能评分，但在吸烟变量上没有差异。TQD与注册同一天的个人拥有最高的登录次数，页面浏览量，使用该工具设置的TQD数量以及发送给其他成员的消息。Logistic回归显示，30天ppa的TQD数量和网站登录次数之间存在显著的相互作用（P=.005）。在登录次数较多的患者中，41.8%（33/79）的1次TQD患者禁欲，而25.9%（35/135）的2次TQD患者禁欲。在CART模型中，登录和自我效能预测了30天的ppa。在标准或探索性分析中，TQD时间不能预测戒烟结局。自我效能感和对初始TQD的明显承诺是与禁欲最高度相关的组成部分，但仅通过与网站利用率的相互作用。研究结果强调了有效处理特定吸烟情况和参与治疗的重要性。需要更多的研究，重点是增加参与基于网络的戒烟研究。ClinicalTrials.gov：NCT 00282009; http://clinicaltrials.gov/show/NCT00282009（由WebCite在http：//www.webcitation.org/6Kt7NrXDl上存档）。
Setting a target quit date (TQD) is often an important component in smoking cessation treatment, but ambiguity remains concerning the optimal timing (ie, quitting spontaneously versus delaying to prepare). We examined four questions about the timing of TQDs and smoking outcomes in secondary analyses of The iQUITT Study, a randomized trial of Internet and telephone treatment for cessation: (1) What are the characteristics of TQDs set using an online interactive quit date tool?, (2) What are the characteristics of individuals who use a quit date tool and do they differ from those who do not?, (3) Are there differences in smoker characteristics, treatment utilization, and cessation outcomes based TQD timing?, and (4) Is maintenance of an initial TQD predictive of abstinence or do changes to TQDs lead to cessation? A total of 825 adult current cigarette smokers were randomized to enhanced Internet or enhanced Internet plus telephone counseling. Latency to TQD in days was calculated as the date difference between the initial TQD and enhanced Internet registration; prospective TQD setters were stratified into four latency groups (0, 1-14, 15-28, 29+ days). Baseline variables, website utilization, and 3-month cessation outcomes were examined between prospective TQD groups. Desire and confidence to quit, number of TQDs, and website logins were tested as predictors of 30-day point prevalence abstinence (ppa) at 3 months (responder-only analyses). Classification and regression tree (CART) analysis explored interactions among baseline variables, website utilization, and latency to TQD as predictors of 30-day ppa. There were few baseline differences between individuals who used the quit date tool and those who did not. Prospective TQDs were set as follows: registration day was 17.1% (73/427), 1-14 days was 37.7% (161/427), 15-28 days was 18.5% (79/427), and 29+ days was 26.7% (114/427). Participants with a TQD within 2 weeks had higher baseline self-efficacy scores but did not differ on smoking variables. Individuals whose TQD was the same day as registration had the highest logins, page views, number of TQDs set using the tool, and messages sent to other members. Logistic regression revealed a significant interaction between number of TQDs and website logins for 30-day ppa (P=.005). Among those with high logins, 41.8% (33/79) with 1 TQD were abstinent versus 25.9% (35/135) with 2+TQDs. Logins and self-efficacy predicted 30-day ppa in the CART model. TQD timing did not predict cessation outcomes in standard or exploratory analyses. Self-efficacy and an apparent commitment to an initial TQD were the components most highly related to abstinence but only via interactions with website utilization. Findings highlight the importance of feeling efficacious about handling specific smoking situations and engaging with treatment. Additional research focused on increasing engagement in Web-based cessation studies is needed. ClinicalTrials.gov: NCT00282009; http://clinicaltrials.gov/show/NCT00282009 (Archived by WebCite at http://www.webcitation.org/6Kt7NrXDl).
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
12.7
作者：
Cobb NK;Graham AL;Abrams DB
通讯作者：
Abrams DB
影响因子：
4.4
作者：
Borrelli, B;Mermelstein, R
通讯作者：
Mermelstein, R
影响因子：
7.4
作者：
An LC;Schillo BA;Saul JE;Wendling AH;Klatt CM;Berg CJ;Ahulwalia JS;Kavanaugh AM;Christenson M;Luxenberg MG
通讯作者：
Luxenberg MG
影响因子：
7.4
作者：
Bock BC;Graham AL;Whiteley JA;Stoddard JL
通讯作者：
Stoddard JL