Mindfulness-based Smoking Cessation Enhanced with Mobile Technology for Low-Income Smokers

项目总结/摘要 烟草使用是癌症的主要行为风险因素，是可预防疾病的主要原因， 低社会经济地位（SES）的成年人和某些种族/少数民族的成员 这些群体戒烟的可能性较小，因此与烟草有关的癌症差异很大。那里 迫切需要改进基于证据的戒烟干预措施，以更好地为这些人服务。 人口。正念训练大大提高了戒烟率和恢复率。那里 缺乏对低社会经济地位和种族/少数民族群体的正念研究，但这些干预措施确实 在这些人群中显示出戒烟的希望。但是，额外的会话间支持可能 这些吸烟者需要，他们在戒烟方面遇到了重大的日常障碍， 戒烟资源移动的医疗技术（mHealth）可以为低收入人群提供至关重要的24/7支持。 SES吸烟者。例如，个性化的交互式mHealth消息可能会鼓励参与者使用 正念和其他戒烟技术在他们最需要的时候（例如，在 高压力或渴望的时间），从而提高治疗效果。基于来自低- SES，种族/民族多样化的吸烟者，我们开发了一个短信程序（“iQuit Mindfully”）， 辅助以正念为基础的戒烟治疗。我们的试点工作表明，iQuit 正念是可行的，可接受的，也许是最有效的低SES吸烟者（即，23.1%的参与者 接受iQuit Mindfully治疗的贫困患者在治疗结束和1个月随访时实现了禁欲， 而那些生活贫困的人中没有一个人放弃了面对面的治疗）。在试点工作的基础上，我们将 整合参与者反馈，进一步增强互动性和个性化， 更灵活地适应参与者不断变化的需求。本项目的具体目标是：1）测试功效 通过mHealth（iQuit Mindfully）增强的基于正念的戒烟干预，与 人正念为基础的成瘾治疗（MBAT）和日常护理;和2）调查的机制 通过MBAT和iQuit Mindfully影响戒烟使用密集的每日日记评估。 该项目旨在通过以下方式改善低SES、种族/民族多样化吸烟者的戒烟结果： 用创新的mHealth方法补充现有的正念治疗。此外，我们的目标是 推进正念治疗的作用机制的科学研究，这可以告知 开发更有效的治疗方法，以减少与烟草有关的癌症差异。

Project Summary/Abstract Tobacco use, a primary behavioral risk factor for cancer, is the leading cause of preventable morbidity and mortality in the U.S. Adults with low socioeconomic status (SES) and members of certain racial/ethnic minority groups are less likely to quit and consequently experience profound tobacco-related cancer disparities. There is an urgent need to improve upon evidence-based smoking cessation interventions to better serve these populations. Mindfulness training substantially increases rates of smoking cessation and lapse recovery. There is a dearth of research on mindfulness in low-SES and racial/ethnic minority groups, but these interventions do show promise for smoking cessation in these populations. However, additional between-session support may be needed for these smokers, who experience significant day-to-day barriers to quitting and have lower access to smoking cessation resources. Mobile health technology (mHealth) could provide vital 24/7 support for low- SES smokers. For example, personalized, interactive mHealth messages might encourage participants to use mindfulness and other smoking cessation techniques in the moments when they need them most (e.g., in times of high stress or craving), thus enhancing treatment effectiveness. Based on iterative feedback from low- SES, racially/ethnically diverse smokers, we developed a text messaging program (“iQuit Mindfully”) as an adjunct to in-person mindfulness-based smoking cessation treatment. Our pilot work demonstrates that iQuit Mindfully is feasible, acceptable, and perhaps most effective for low-SES smokers (i.e., 23.1% of participants living in poverty who received iQuit Mindfully achieved abstinence at end of treatment and 1-month follow-up, while none of those living in poverty quit in the in-person-only treatment). Building on this pilot work, we will incorporate participant feedback to further increase interactivity and personalization so that iQuit Mindfully can more flexibly adapt to participants’ changing needs. The specific aims of this project are to: 1) Test the efficacy of a mindfulness-based smoking cessation intervention enhanced by mHealth (iQuit Mindfully), compared to in- person mindfulness-based addiction treatment (MBAT) and usual care; and 2) Investigate the mechanisms through which MBAT and iQuit Mindfully impact smoking cessation using intensive daily diary assessment. This project aims to improve cessation outcomes for low-SES, racially/ethnically diverse smokers by supplementing existing mindfulness treatment with innovative mHealth methods. Furthermore, we aim to advance the scientific study of mechanisms of action of mindfulness treatment, which could inform the development of more efficacious and efficient treatments to reduce tobacco-related cancer disparities.