A NOVEL HARM REDUCTION APPROACH FOR RESISTANT SMOKERS

吸烟风险与剂量密切相关。研究表明，随着每日吸烟量的增加，肺癌的风险从10倍跃升至70倍。减少烟草暴露及其相应的危害是转变不愿意或不能承诺戒烟的抵抗性吸烟者的第一步。传统上，戒烟计划的目标是高度积极的吸烟者准备戒烟或采取行动。然而，80%的烟草使用者在未来六个月内不打算尝试。50%的人永远不会放弃。原因包括不愿意放弃快乐，过去的失败令人沮丧，以及对副作用的不容忍。偶尔，“盔甲上的裂缝”会出现，吸烟者会开始认真地削减。人们越来越认识到，减少吸烟是使顽固性烟草使用者走向减少危害和后期改变的第一步，包括戒烟的理想。减少吸烟可能会深入到那些在其他方面反应迟钝的前吸烟和顽固人群。成功地实现更有限的目标可能会重建自我效能感的损失。这项研究将展示一项技术突破，提供预定的减量方案，将使用量减少到并维持在基线的50%。先进的生物标志物将证实致癌物、毒素和尼古丁的摄入减少。拟议的商业应用：对于4800万不愿意或不能戒烟的吸烟者中的80%，目前还没有广泛的协议或商业交付工具。这种用于定期减少的非处方治疗设备被用作：（1）针对最难治性吸烟者的高效自助行为治疗，（2）其他医疗护理的辅助手段，以及（3）精确监测和定制治疗的研究工具。

Smoking risks are strongly dose-related. Lung cancer risks are shown to leap from 10-fold to 70-fold with increased daily cigarette consumption. To reduce tobacco exposure and its corresponding hazards is a first step in transitioning resistant smokers who are unwilling or unable to commit to quitting. Traditionally, abstinence programs target the highly- motivated smoker ready to quit or take action. 80% of tobacco users, however, do not plan an attempt in the next six months. 50% will never quit. Reasons cited include unwillingness to forego the pleasure, discouragement with past failures, and intolerance of side effects. Occasionally, a "chink in the armor" appears and smokers become open to seriously cutting back. Smoking reduction is increasingly recognized as a first step in moving refractory tobacco users toward harm reduction and later stages of change, including the ideal of abstinence. Smoking reduction may reach deeper into pre-contemplative and intransigent segments who are otherwise unresponsive. Success at achieving more limited goals may rebuild self-efficacy loss. This study will demonstrate a technological breakthrough that delivers a scheduled reduction regimen programmed to decrease to and maintain usage at 50% of baseline. Sophisticated biomarkers will verity reduction in uptake of carcinogens, toxins and nicotine. PROPOSED COMMERCIAL APPLICATIONS: No broad-based protocol or commercial delivery instrument presently exists for the 80% of the 48-million smokers who are unwilling or unable to quit. This over-the-counter therapy device for scheduled reduction is used as: (1) a highly-effective self-help behavioral treatment for the most refractory smokers, (2) an adjunct to other medical care, and (3)a research tool to precisely monitor and tailor treatments.