Efficiency of sustained cessation for population

人群持续戒烟的效率

• 批准号: 6659209
• 负责人: David Brian Abrams
• 金额: $ 16.54万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6659209
• 关键词: clinical research; counseling; disease /disorder proneness /risk; human subject; human therapy evaluation; interview; smoking cessation; tobacco abuse

DESCRIPTION: (Applicant's Description) There has been insufficient research on how best to translate effective smoking cessation treatments into efficient public health interventions. Public health interventions reach many through proactive recruitment but are efficacious with few, while clinic- based interventions reach few, (reactive and self-selected), but are effective. Lifetime comorbid risk can also attenuate the efficiency of both clinical and public health interventions. A significant proportion of adult smokers are at high risk for smoking treatment failure by virtue of comorbidity (i.e., nicotine dependent, psychiatric comorbidity, multiple psychosocial barriers to quitting). The influence of familial, prenatal nicotine exposure, and early childhood risk factors on adult response to treatment has not been examined in any study we are aware of. We will recruit subjects proactively from the transgenerational longitudinal National Collaborative Perinatal Project (NCPP) who are now aged 34 to 40 - the G2 generation. The G2's have been followed since birth and detailed information is available on prospective prenatal, postnatal, and early childhood risk factors. During baseline structured interviews of the (32 generation of the NCPP, we will also gather expensive lifetime and concurrent data on adult smoking patterns and co- morbid risk factors for smoking treatment failure. Thus we propose to investigate the relationship between familial, early childhood and adult lifetime risk factors and response to treatment in a proactively recruited sample from the NCCP longitudinal cohort. This study also seeks to bridge the gap between public health and clinical interventions by coupling the advantages of a public health approach (proactive reach) with the advantages of a more intensive clinical strategy (multi-modal, sustained contact). The primary aims are: 1) to compare the efficacy of two smoking cessation interventions, Brief Telephone Counseling (BTC) and Sustained Multi-Modal Counseling (SMC) in a randomized trial of 780 subjects followed for 24 months after baseline and, 2) to examine the relationship between early childhood and adult lifetime high and low risk profiles and treatment response. We will also examine cost-effectiveness and conduct program and process to outcomes analysis to examine the dosage of intervention delivered and received. A transdisciplinary approach at the interface between clinical and public health interventions, using a common community sample drawn from the trans- generational NCPP study, can advance the understanding of basic bio- behavioral mechanisms in nicotine dependence, lifetime risk factors and the interactions of these variables with treatment response.

产品说明：关于如何最好地将有效的戒烟治疗转化为有效的公共卫生干预措施的研究不足。公共卫生干预措施通过积极主动的招聘达到许多人，但对很少人有效，而基于诊所的干预措施达到很少人（被动和自我选择），但有效。终生共病风险也会削弱临床和公共卫生干预措施的效率。相当大比例的成年吸烟者由于合并症而处于吸烟治疗失败的高风险中（即，尼古丁依赖、精神共病、戒烟的多重社会心理障碍）。我们所知道的任何研究都没有研究过家庭、产前尼古丁暴露和儿童早期风险因素对成人治疗反应的影响。我们将从跨代纵向国家围产期合作项目（NCPP）中积极招募年龄在34至40岁的受试者-G2代。G2从出生起就一直被跟踪，并提供有关产前、产后和幼儿期风险因素的详细信息。在第32代NCPP的基线结构化访谈期间，我们还将收集关于成人吸烟模式和吸烟治疗失败的共病风险因素的昂贵的终生和同期数据。因此，我们建议在NCCP纵向队列的主动招募样本中调查家族性、幼儿期和成人期风险因素与治疗反应之间的关系。本研究还试图通过将公共卫生方法（主动接触）的优势与更密集的临床策略（多模式，持续接触）的优势相结合，弥合公共卫生和临床干预之间的差距。主要目标是：1）在一项随机试验中比较两种戒烟干预措施的有效性，即简短电话咨询（BTC）和持续多模式咨询（SMC），该试验对780名受试者进行了基线后24个月的随访，2）检查幼儿和成人之间的关系终生高、低风险状况和治疗反应。我们还将审查成本效益，并进行计划和过程的结果分析，以检查提供和接收的干预剂量。在临床和公共卫生干预之间的接口处采用跨学科方法，使用从跨代NCPP研究中提取的共同社区样本，可以促进对尼古丁依赖的基本生物行为机制、终生风险因素以及这些变量与治疗反应的相互作用的理解。