CERVICAL ABNORMALITIES AND SMOKING

广泛的流行病学证据现在支持因果关系， 吸烟与宫颈癌此外，可替宁在 吸烟者的宫颈粘液表明， 吸烟和早期宫颈异常。妇科年度常规 考试提供了一个机会：提供与吸烟有关的信息 生殖健康结果，增强戒烟的动机 并增加育龄妇女戒烟的可能性。 建议进行一项随机试验，以评估最先进的吸烟是否 作为Pap常规随访的一部分提供戒烟干预 相对于常规护理，检查可以增加戒烟率。第二 目的是评估是否通知异常测试结果 增强戒烟的动机和可能性。 这项研究将在普吉特海湾的团体健康合作社进行。 将对自动宫颈细胞学数据库进行审查， 最近的巴氏筛查700名吸烟者（350名测试正常 结果和350个正常结果）将通过 基于人口的妇女健康电话调查。吸烟者将 根据巴氏试验结果分层并随机接受两种干预措施之一 条件：第1组，常规护理或第2组，自助与激励 是的。随机分配到第1组的吸烟者将接受通常的标准 提供者形式的护理：评估吸烟状况，建议戒烟 吸烟，转诊到可用的戒烟援助，以及 关于吸烟和总体健康的信息/激励小册子 生殖健康。第二组的吸烟者将获得自助服务。 小册子、书面个性化反馈和3个电话， 戒烟顾问戒烟结果，包括阶段 戒烟，戒烟动机的水平和类型，初始戒烟 在基线、6个月和15个月时获得持续戒烟 后续电话调查。 该项目的首要目标是确定有效的癌症 健康女性吸烟者的预防干预策略。

Extensive epidemiologic evidence now supports a causal association between smoking and cervical cancer. Moreover, detection of cotinine in the cervical mucus of smokers suggests a biologically plausible link between smoking and early cervical abnormalities. Annual routine gynecological exams represent an opportunity to: provide information which links smoking to reproductive health outcomes, enhance motivation for smoking cessation and increase the likelihood of cessation in reproductive age women. Proposed is a randomized trial to assess whether state-of-the-art smoking cessation interventions provided as part of routine follow-up for Pap exams can increase cessation rates relative to usual care. A second objective is to assess whether notification of abnormal test results enhances motivation for and likelihood of smoking cessation. The research will be conducted at Group Health Cooperative of Puget Sound. An automated cervical cytology database will be reviewed to identify recent Pap screenees. A cohort of 700 smokers (350 with normal test results and 350 with a normal results) will be identified through a population based women's health telephone survey. Smokers will be stratified on Pap test result and randomized to one of two intervention conditions: Group 1, usual care or Group 2, self-help with motivational adjuncts. Smokers randomized to Group 1 will receive the usual standard care in the form of provider: assessment of smoking status, advice to quit smoking, referral to available assistance for smoking cessation, and an informational/motivational pamphlet regarding smoking and overall reproductive health. Smokers assigned to Group 2 will receive a self-help booklet, written personalized feedback and 3 telephone calls from a cessation counselor. Smoking cessation outcomes including stage of cessation, level and type of motivation to quit smoking, initial cessation and sustained abstinence will be obtained at baseline, 6 and 15 month follow-up telephone surveys. The overarching goal of the project is to identify effective cancer prevention intervention strategies for healthy women smokers.