Internet and Telephone Treatment for Smoking Cessation

描述(由申请人提供)：在美国，烟草使用是癌症和疾病负担的主要可预防原因。虽然存在有效的治疗方法，但需要创新的有效提供方式来加速降低吸烟率。电话咨询和量身定做的自我改变计划具有有效性的证据基础，并有能力对人口流行率产生影响。通过电话戒烟专线和通过互联网进行量身定做的自我改变，提供全面的烟草控制服务的运动越来越多。科学家、政策制定者和公众需要知道这些计划是否有效，对谁有效，通过什么机制，以什么成本。目前还没有对互联网驱动的戒烟服务或电话和互联网联合治疗的效果进行严格的评估。与此同时，基于互联网的程序已经向公众提供，并在没有任何证据表明它们有效的情况下得到了非常大量的使用。 这项研究旨在通过比较流行的、全面服务的互联网干预(高级互联网)单独或与主动电话咨询(高级互联网+电话)和标准互联网控制(基本互动)的有效性来扩展现有的理论和应用。这项研究将招募有动力的吸烟者(N=2,055)，他们使用互联网搜索引擎来寻找戒烟计划。子集将被定向到一个网页，该网页将描述学习和注册程序。采用3条件随机设计，在基线、随机后3、6、12和18个月重复测量，同意的吸烟者将被分配到：1)基本互联网；2)高级互联网；3)高级互联网+主动电话咨询。测试的假设是，Premium InterAct加电话的表现将优于单独使用Premium互联网，两者在随机化后12个月(治疗后6个月)衡量的7天点戒断率方面都将优于基本互联网。成本效益也将与对理论驱动的假设的探索性分析一起进行，这些假设涉及结果的中介和调节变量(例如，性别、服务使用量和频率、使用的内容类型以及包括自我效能、社会支持和动机在内的行为改变变量)。 市场需求和国家卫生部门正在刺激互动和电话戒烟服务的提供。迫切需要科学来填补这一空白，并评估它们的有效性。如果有效，这种治疗方法可以广泛传播，并对人口健康产生重大影响。

DESCRIPTION (provided by applicant): Tobacco use is the major preventable cause of cancer and disease burden in the U.S. While effective treatments exist, innovative means of efficient delivery are needed to accelerate reduction in smoking prevalence. Telephone counseling and tailored self-change programs have an evidence-base of efficacy and the capability to make an impact on population prevalence. There is a growing movement to provide comprehensive tobacco control services, both through telephone quit lines and tailored self-change via the Internet. Scientists, policy makers and the public need to know if these programs work, for whom, by what mechanisms, and at what cost. There are no rigorous evaluations of the efficacy of Internet-driven cessation services or of combined telephone and Internet treatment At the same time, Internet-based programs are already available to the public and are being used at a very high volume without any evidence that they are effective. This study aims to extend existing theory and application by comparing the efficacy of a popular, full service, Internet intervention (Premium Internet) alone or in conjunction with proactive telephone counseling (Premium Internet plus Telephone) against a standard Internet control (Basic Interact). This study will recruit motivated smokers (N=2,055) who use an Internet search engine to find smoking cessation programs. A subset will be directed to a Web page that will describe the study and enrollment procedures. Using a 3-condition randomized design with repeated measures at baseline, 3, 6, 12, and 18-months post-randomization, consented smokers will be assigned to: 1) Basic Internet; 2) Premium Internet; and 3) Premium Internet plus Proactive Telephone Counseling. The hypotheses tested are that Premium Interact plus Telephone will outperform Premium Internet alone and both will outperform Basic Internet on 7-day point prevalence abstinence measured at 12 months post-randomization (6-months post treatment). Cost-effectiveness will also be examined along with exploratory analyses of theory-driven hypotheses about the mediators and moderators of outcome (e.g., gender, amount and frequency of service use, type of content used, and behavior change variables including self-efficacy, social support, and motivation). Market demand and State health departments are stimulating delivery of Interact and telephone cessation services. There is an urgent need for science to fill the gap and evaluate their efficacy. If effective, such treatments can be widely disseminated and can make a significant impact on population health.