Early Withdrawal Exposure and Negative Affect Withdrawal (NAW) Regulation Training for Smoking Cessation

在美国，吸烟仍然是导致死亡和发病的唯一最可预防的原因。 即使是最严格的戒烟治疗的长期戒烟率也在20%到20%之间。 和35%。因此，继续研究新的戒烟干预措施至关重要。 当代主要的成瘾动机理论认为，逃避或避免负面影响， 戒断（NAW）症状（例如，愤怒、焦虑和抑郁/悲伤）构成了强烈的动机 吸烟是吸烟的基础，在吸烟复发中起着关键作用。然而，尽管NAW 症状似乎对戒烟治疗结果产生了强大的影响， 干预可能对NAW症状仅产生适度的影响。因此，有人提议， 通过帮助吸烟者实施NAW法规，可以加强戒烟干预 战略布局本研究的主要目的是评价提前停药暴露加NAW 规范戒烟培训干预。具体目标包括评估 治疗组分和研究治疗组分的潜在介质和调节剂。 受试者将是每天至少吸烟5支并打算戒烟的成年吸烟者（N = 400）。 使用析因设计，受试者将随机接受提前退出暴露（是vs.否）， 行为干预（NAW调节训练与放松控制训练），导致四种不同的 条件我们的主要假设是，早期戒断暴露加上NAW调节训练将产生 治疗结束后1、3和6个月的7天时点戒烟率较高，表明 协同（即，非加性）两种干预成分的效果。调解人（例如，会期 戒断症状）和调节剂（例如，人口特征，烟草依赖）将是 通过已建立的分析。这些数据将推进实验性干预，重点是 针对变革机制以及干预可能针对的参与者特征， 量身定做的目前提案中描述的实验性干预有可能最终 提高现有戒烟干预措施的有效性，因此将为 领域

Cigarette smoking remains the single most preventable cause of mortality and morbidity in the United States. Long-term abstinence rates for even the most rigorous of smoking cessation treatments range between 20% and 35%. It is therefore essential that research continue to investigate novel smoking cessation interventions. Leading contemporary theories of addiction motivation posit that the escape or avoidance of negative affect withdrawal (NAW) symptoms (e.g., anger, anxiety, and depression/sadness) constitutes a strong motivational basis for cigarette smoking and plays a critical role in relapse to cigarette use. However, whereas NAW symptoms appear to exert a powerful influence on smoking cessation treatment outcome, smoking cessation interventions may exert only modest effects on NAW symptoms. Accordingly, it has been proposed that smoking cessation interventions may be augmented by aiding smokers in the practice of NAW regulation strategies. The primary goal of this investigation is to evaluate an early withdrawal exposure plus NAW regulation training intervention for smoking cessation. Specific aims include evaluating the efficacy of the treatment components and investigating potential mediators and moderators of the treatment components. Participants will be adult smokers (N = 400) of at least 5 cigarettes per day with the intention to quit smoking. Using a factorial design, participants will be randomized to early withdrawal exposure (yes vs. no) and behavioral intervention (NAW regulation training vs. relaxation control training), resulting in four distinct conditions. Our primary hypothesis is that early withdrawal exposure plus NAW regulation training will produce higher rates of seven-day point-prevalence abstinence at 1, 3, and 6 months after end-of-treatment, suggesting a synergistic (i.e., non-additive) effect of the two intervention components. Mediators (e.g., in-session withdrawal symptoms) and moderators (e.g., demographic characteristics, tobacco dependence) will be investigated via established analyses. These data will advance the experimental intervention with a focus on targeting mechanisms of change as well as participant characteristics to which the intervention may be tailored. The experimental intervention described in the current proposal has the potential to ultimately enhance the efficacy of existing smoking cessation interventions and will therefore contribute uniquely to the field.