Group-based Cognitive-Behavioral Therapy among African Smokers: An Efficacy Test

非洲吸烟者的团体认知行为疗法：功效测试

• 批准号: 7226847
• 负责人: MONICA WEBB HOOPER
• 金额: $ 7.38万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-28 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7226847
• 关键词: clinical research; conditioning; health; nicotine; nicotine replacement; smoking; smoking cessation

DESCRIPTION (provided by applicant): Tobacco smoking is the leading cause of preventable death and disease in the United States. Tobacco use claims the lives of over 176,000 Americans due to cancer each year. Compared to Caucasians, African American smokers suffer disproportionately from smoking-related illnesses. Few studies have tested the efficacy of smoking cessation treatments with representative samples of African Americans. A recent meta- analysis suggested that group counseling is among the most efficacious treatments for this population; yet, this conclusion was based on only two studies. The current application will test of the feasibility and efficacy of an established cognitive-behavioral smoking intervention among African American adults. Identifying whether this treatment is also beneficial for African Americans has theoretical and applied implications that transcend this project. The specific aims of the study will be (1) to examine the feasibility of conducting an intensive group cognitive behavioral intervention plus nicotine replacement in a sample of African American smokers, (2) to test the efficacy of the intervention, and (3) to begin exploratory analyses of predictors of successful smoking cessation (nicotine dependence, smoking outcome expectancies, health locus of control, cessation self-efficacy, and treatment utilization). To accomplish this, 80 smokers will be randomized to receive either a two-week group cognitive behavioral smoking intervention plus nicotine patch therapy (NPT), or a two-week health education intervention plus nicotine patch therapy. The group treatment will be based on an efficacious cognitive behavioral treatment (CBT) that includes education on tobacco addiction, the time-course of nicotine withdrawal, positive reinforcement, self-monitoring, identification of high-risk situations, coping skills training, and contingency contracting. The health education intervention (HE), a time and attention matched control condition, will present didactic information on a variety of health topics other than smoking cessation. Our primary outcomes will be point-prevalence abstinence, both 24-hour and 7- day, and 28-day continuous abstinence. Participants will be assessed post treatment (two weeks), and at three and six months post treatment. Thus, we will use a 2 (intervention) x 3 (time) design. It is hypothesized that the CBT plus NPT condition will demonstrate greater smoking cessation at each assessment compared to the HE plus NPT condition. It is also expected that baseline nicotine dependence, positive smoking outcome expectancies, and external health locus of control will be negatively associated with smoking cessation success. Intervention utilization will be positively associated with smoking cessation. The long term objective of this work is to advance the field by informing the development of smoking cessation treatments for African American smokers. This has important public health implications related to reducing smoking-related health disparities.

描述（由申请人提供）：吸烟是美国可预防的死亡和疾病的主要原因。烟草使用每年夺去超过176，000名美国人因癌症而死亡。与白人相比，非裔美国人吸烟者患吸烟相关疾病的比例更高。很少有研究用非裔美国人的代表性样本来测试戒烟治疗的疗效。最近的一项Meta分析表明，团体咨询是对这一人群最有效的治疗方法之一;然而，这一结论仅基于两项研究。目前的应用程序将测试在非洲裔美国成年人中建立的认知行为吸烟干预的可行性和有效性。确定这种治疗方法是否对非裔美国人也有益，具有超越该项目的理论和应用意义。本研究的具体目的是：（1）检查在非裔美国吸烟者样本中进行强化群体认知行为干预加尼古丁替代的可行性;（2）测试干预的有效性;（3）开始探索性分析成功戒烟的预测因素（尼古丁依赖、吸烟结果预期、健康控制点、戒烟自我效能和治疗利用）。为了实现这一目标，80名吸烟者将随机接受为期两周的小组认知行为吸烟干预加尼古丁贴片治疗（NPT），或为期两周的健康教育干预加尼古丁贴片治疗。小组治疗将基于有效的认知行为治疗（CBT），包括烟草成瘾教育、尼古丁戒断的时间进程、积极强化、自我监测、识别高风险情况、应对技能培训和应急合同。健康教育干预（HE）是一种时间和注意力匹配的对照条件，将提供有关戒烟以外的各种健康主题的教学信息。我们的主要结果将是24小时和7天以及28天连续禁欲的点流行率。参与者将在治疗后（两周）以及治疗后三个月和六个月进行评估。因此，我们将使用2（干预）× 3（时间）设计。据推测，与HE + NPT条件相比，CBT + NPT条件将在每次评估时表现出更大的戒烟效果。预计基线尼古丁依赖、积极的吸烟结果预期和外部健康控制点与戒烟成功率呈负相关。干预措施的使用将与戒烟呈正相关。这项工作的长期目标是通过为非裔美国人吸烟者提供戒烟治疗的发展信息来推动该领域的发展。这对减少与吸烟有关的健康差距具有重要的公共卫生影响。