Exercise to Aid Smoking Cessation in Adolescent Girls

描述(由申请人提供)： 目前约有22%的年轻人吸烟，尽管吸烟增加了患癌症和心血管疾病的风险。烟草使用仍然是美国成年人死亡的主要、可预防的原因。研究表明，那些在14-26岁之间第一次吸烟的人更有可能对尼古丁产生依赖，因此比起那些较晚开始吸烟的人，他们对戒烟努力更具抵抗力。虽然女孩的吸烟率在1970年的S和1980年的S期间有所下降，但目前高中女孩的吸烟率在1998年至2000年期间保持不变。尽管吸烟会对健康造成负面影响，但事实证明，对体重的担忧和对体重增加的恐惧与女孩吸烟有关。或者，运动已被证明是一种积极的健康行为，并可以提供与吸烟相同的感知好处：自尊、放松、体重控制。在之前的成年女性试验中，大强度运动被证明有助于戒烟。因此，本研究将采用有效的基于群体的认知行为戒烟治疗加运动来满足青春期女孩的需求。该项目将分为两个阶段。在该项目的第一阶段，将举办4个重点小组(每个小组由8-10名少女组成)，以适应干预措施。调整将包括使材料、干预内容和语言适合青年并与之相关。该项目的第二阶段将包括一项随机试点研究，其中40名青春期女孩将被随机分配到：a)标准认知行为戒烟加锻炼(CBT+锻炼)或b)同等接触时间的标准戒烟(标准+接触)。收集样本，治疗12周，随访3个月。戒烟结果(持续戒烟)将通过唾液可替宁进行验证。锻炼的遵守情况将通过参加监督会议和客观监测来验证。二次分析，提出了行为改变的理论中介，包括体重担忧和自我效能感。主要的假设是CBT+运动组的女孩比标准+接触组的女孩有更高的戒烟率。综上所述，我们寻求：1)进行形成性工作，使戒烟材料和锻炼方案从关注成年女性转向青春期女孩，以及2)进行小规模随机试点试验，以确定干预措施在青春期女孩样本中的初步效果。因此，这项研究将作为更大规模临床试验的先导。在青春期女孩中成功戒烟可能有助于未来降低这一群体的慢性病死亡率。

DESCRIPTION (provided by applicant): Approximately 22% of youth currently smoke cigarettes despite the increased risk of cancer and cardiovascular disease associated with cigarette use. Tobacco use continues to be the leading, preventable cause of mortality among US adults. Research has shown that those who smoke their first cigarette between the ages of 14-26 are more likely to become nicotine dependent, and, therefore, more resistant to smoking cessation efforts, than those initiating smoking at a later age. Although the smoking prevalence among girls declined in the 1970's and 1980's, the current smoking rates among high school girls has held constant from 1998 to 2000. Despite the negative health consequences associated with smoking, weight concerns and fear of weight gain have been shown to be associated with the uptake of smoking in girls. Alternatively, exercise has been shown to be a positive health behavior, and can provide the same perceived benefits of smoking: self-esteem, relaxation, weight management. In previous trials in adult women, vigorous intensity exercise has been shown to be effective for aiding with smoking cessation. Therefore, this study will adapt the efficacious group-based cognitive behavioral smoking cessation treatment plus exercise to meet the needs of adolescent girls. This project will consist of two phases. In Phase I of this project, 4 focus groups will be conducted (each consisting of 8-10 adolescent girls) to adapt the intervention. Adaptations will include making the materials, intervention content, and language age-appropriate and relevant for youth. Phase II of the project will consist of a randomized pilot study in which 40 adolescent girls will be randomly assigned to: a) standard cognitive-behavioral smoking cessation plus exercise (CBT+Exercise) or b) standard cessation with equal contact time (Standard+Contact). The sample will be recruited, treated for 12 weeks and followed for 3 months. Smoking cessation outcome (continuous abstinence) will be validated by saliva cotinine. Exercise adherence will be validated by attendance at supervised sessions, and objective monitoring. Secondary analysis, of proposed theoretical mediators of behavior change will be conducted, including weight concerns and self-efficacy. The primary hypothesis is that girls in the CBT+Exercise group will have higher quit rates than girls in the Standard+Contact group. In summary, we seek to:1) conduct the formative work to adapt the cessation materials and exercise protocol from a focus on adult women to adolescent girls, and 2) conduct a small randomized pilot trial to determine the preliminary efficacy of the intervention in a sample of adolescent girls. Therefore, this study will serve as a pilot for a larger clinical trial. Successful smoking cessation in adolescent girls could contribute to the future reduction of chronic disease mortality in this group.