FIELD STUDY OF SMOKING CESSATION IN ALCOHOLISM TREATMENT

申请者摘要：这项研究的目的是增进理解 关于影响治疗的烟酒相互作用过程 酒精和尼古丁联合依赖的人。治疗 结果方法论将与复杂的生态学瞬间相结合 评估方法，以检查吸烟的程度 作为酒精渴望的提示和/或对酒精渴望的反应 治疗过的酗酒者。这项研究的次要目标将是检查 实施戒烟干预对治疗结果的影响 同时对酒精依赖进行非卧床治疗。如果吸烟 进一步分析发现，戒烟治疗会影响饮酒结果 将进行调查，以确定可能的调解人的影响 戒酒自我效能感与酒精相关应对的影响 技能。研究对象为112名要求饮酒的酗酒者 接受治疗，并愿意尝试戒烟。主题将是 参加纽灵顿药物滥用日活动的退伍军人 和弗吉尼亚州康涅狄格州医疗保健系统的西黑文校园。 非退伍军人妇女将从社区招募并参加 日间计划，以确保充分的性别代表性。一周后 进入日间计划，受试者将被随机分配到以下其中之一 以下两个条件：(1)强化戒烟治疗 (行为咨询+尼古丁贴片尼古丁替代) 同时接受酒精治疗，或(2)简短的戒烟建议 同时进行酒精治疗。在完成这一天的前两天 计划中，受试者将被指导自我监控情绪， 情况，饮酒，吸烟和冲动饮酒或吸烟使用手持 一台每天随机4次发出蜂鸣音进行评估的计算机。 他们还将被指示在紧接之前激活计算机， 然后跟着抽，每天抽四支烟。离开后 他们将继续自我监测14天的治疗。结果将是 在治疗后14天、3个月和6个月使用 访谈、问卷调查和生物学测量。

APPLICANT'S ABSTRACT: This study was designed to increase understanding about the alcohol-tobacco interaction processes that impact the treatment of individuals with combined alcohol and nicotine dependence. Treatment outcome methodology will be combined with sophisticated Ecological Momentary Assessment methodology in order to examine the extent to which smoking serves as a cue for alcohol craving and/or a response to alcohol craving in treated alcoholics. A secondary aim of the study will be to examine treatment outcome effects of delivering a smoking cessation intervention concurrent with ambulatory treatment for alcohol dependence. If smoking cessation treatment is found to affect alcohol outcome, further analyses will be conducted to determine the impact of possible mediators of this effect such as alcohol abstinence self-efficacy and alcohol-related coping skills. Subjects will be 112 alcoholics who have requested alcohol treatment and are willing to attempt smoking cessation. Subjects will be veterans participating in the Substance Abuse Day Programs at the Newington and West Haven campuses of the VA Connecticut Healthcare System. Non-veteran women will be recruited from the community and enrolled in the Day Program to ensure adequate gender representation. One week after admission to the Day Program, subjects will be randomly assigned to one of the following two conditions: (1) Intensive smoking cessation therapy (behavioral counseling plus nicotine replacement using nicotine patches) concurrent with alcohol treatment, or (2) Brief smoking cessation advice concurrent with alcohol treatment. Two days before completing the Day Program, subjects will be instructed in self-monitoring of moods, situations, drinking, smoking and urges to drink or smoke using a hand-held computer that will beep them for assessment at random times 4 times/day. They will also be instructed to activate the computer immediately prior to, and just following, smoking each of four cigarettes per day. After leaving treatment they will continue to self-monitor for 14 days. Outcome will be measured at 14 days, three months and six months posttreatment using interviews, questionnaires, and biological measures.