ALCOHOL CONTROL--SMOKING CESSATION THERAPY

拟议研究的长期目标是发展 恢复吸烟的有效戒烟方法 酗酒者。这一群体的烟草使用率很高。那些 继续吸烟对健康的所有不利影响都有风险 在普通人群中观察到的烟草使用情况。此外，利率 口腔癌和食道癌的发病率远远超过 只喝酒或只抽烟的成年人。具体目标是 先后测试2种最低限度的戒烟干预措施 确定对酒精和烟草使用的长期影响 住宅酒精治疗专业的毕业生。飞行员 阶段性干预将包括医生咨询 并在治疗时提供戒烟自助材料 中心放电。评估阶段干预措施将包括 类似的医生咨询和自助材料，外加3 出院后跟踪健康教育工作者的电话。在……里面 试点阶段，来自1991年内布拉斯加州治疗调查的数据 中心将确定4个对解决尼古丁问题感兴趣的中心 对其客户的依赖，通过聚合支持来衡量 进行戒烟(SFSC)评分。SFSC分数将分配给 这些中心集中在2个层位。在阶层内部，中心将是 随机分为干预组(IN)或常规护理组(UC)。 使用筛查措施来识别吸烟的客户，每个中心 将招募30名客户[N=120]，他们同意6个月的随访和 烟草使用的生理确认。在干预中心， 一名受过专门培训的医生或替代治疗工作人员， 将为客户提供一次性戒烟咨询 出院前立即提供自助材料。 对酒精和烟草使用的后续评估将与 在和UC客户端中，并将在1点和1点通过邮件和电话完成 出院后6个月。受试者将获得10美元的奖励 对于每个已填写的调查问卷。戒烟者将被要求戒烟 提供他们的唾液样本用于可替宁分析以验证 自我报告数据。在评估阶段，扩展的 将使用电话跟踪进行干预。12个中心将 被招募，根据SFSC分数匹配，并随机分配到 处于或UC状态(各6例)。每个评估阶段中心将 注册50个客户端[N=600]。这些参与者将接受评估 与试运行阶段客户端的方式相同，但将遵循 额外的12个月，到18个月的后处理中心 出院。

The long-term objective of the proposed research is development of effective cigarette smoking cessation methods for recovering alcoholics. Tobacco use rates are high in this group. Those who continue to smoke are at risk for all the adverse health effects of tobacco use observed in the general population. Further, rates of oral and esophogeal cancers greatly exceed those observed among adults who only drink or only smoke. The specific aims are to successively test 2 minimal smoking cessation interventions to determine long-term effects on alcohol and on tobacco use among graduates of residential alcohol treatment programs. The pilot phase intervention will include physician counseling and provision of smoking cessation self-help materials at treatment center discharge. The evaluation phase intervention will include similar physician counseling and self-help materials, plus 3 followup telephone calls by health educators after discharge. In the pilot phase, data from a 1991 survey of Nebraska treatment centers will identify 4 centers interested in addressing nicotine dependence in their clients, as measured by the aggregated Support for Smoking Cessation (SFSC) score. The SFSC score will assign these centers to 2 strata. Within strata, centers will be randomized to the intervention (IN) or usual care (UC) condition. Using a screening measure to identify clients who smoke, each center will enroll 30 clients [N = 120] who consent to 6 month followup and physiologic confirmation of tobacco use. In intervention centers, a specially trained physician, or alternate treatment staff member, will deliver one-time smoking cessation counseling to clients immediately prior to discharge and provide self-help materials. Followup assessment of alcohol and tobacco use will be identical for IN and UC clients and will be done by mail and telephone at 1 and 6 months after discharge. Subjects will receive a $10.00 incentive for each completed questionnaire. Tobacco quitters will be asked to provide a sample of their saliva for cotinine analysis to verify self-report data. In the evaluation phase, the expanded intervention with telephone followup will be used. 12 centers will be recruited, matched by SFSC score, and randomly assigned to the IN or UC condition (6 each). Each evaluation phase center will enroll 50 clients [N = 600]. These participants will be assessed in the same manner as pilot phase clients but will be followed for an additional 12 months, to 18 months post treatment center discharge.