A Multilevel Analysis of Predictors of Successful Teen Smoking Cessation in the N

描述（由申请人提供）：项目摘要/摘要毫无疑问，吸烟仍然是美国最重要和最紧迫的公共卫生问题之一。吸烟不仅每年花费超过960亿美元的公共和私人医疗保健费用，而且每年造成近50万人死亡。此外，每一个与烟草有关的死亡，就有20个人患有与烟草有关的疾病。然而，尽管为预防和戒烟进行了研究以及财政和政策努力，但吸烟率在过去几年中保持稳定。然而，特别是对于青少年吸烟者，仍然存在对有效戒烟计划的重大需求。然而，不幸的是，关于成功的青少年戒烟计划的证据有限。因为很少有计划成功，所以对那些参加结构性戒烟计划的青少年的社会人口统计学，心理学和背景特征以及这些特征如何联合收割机影响戒烟成功或失败知之甚少。缺乏此类知识很重要，因为为了将干预措施与最有可能从此类计划中受益的人相匹配，以及为那些在既定干预措施中失败的人修改现有治疗方法，我们必须首先了解这些个人和项目的特征。成功和失败的项目。本研究旨在通过进行广泛的高阶分析来解决这些问题，包括结构方程模型和分层线性模型，最大的青少年吸烟者数据库在一个单一的，经验支持的干预-美国肺脏协会的不吸烟（NOT）计划中进行戒烟治疗。 通过认识和关注青少年吸烟和青少年戒烟的嵌套性质，我们希望将影响戒烟的不同生态和个人层面的变量联系起来;从而阐明个体吸烟者与他/她的近端和远端社会生态之间的复杂相互作用。本研究的贡献将是显着的，因为它将是第一个评估一个大型数据库的青少年寻求戒烟，通过一个单一的经验支持的结构化干预。拟议研究的结果将有助于确定个别因素的作用（例如，吸烟史，尼古丁依赖）以及几个嵌套因素，包括同伴吸烟环境，戒烟团体动力学，学校，社区和州一级的因素。这些知识对于识别有治疗失败风险的青少年，以及在个人、地方和州一级识别可能与戒烟成功或失败有关的关键背景和政策因素至关重要。项目叙述拟议的研究是对青少年戒烟的多层次影响的广泛分析。最先进的统计分析，包括结构方程模型和分层线性模型，将有助于阐明个人因素，父母和同龄人的影响和学校，县和州的因素联合收割机如何结合起来，通过经验支持的戒烟计划来影响寻求戒烟的青少年的结果。拟议的研究与公共卫生和癌症控制相关，因为这项研究有可能指导戒烟招募，计划修改以及学校，县和州有关吸烟的政策。

DESCRIPTION (provided by applicant): Project Summary / Abstract There is little question that cigarette smoking remains one of the nation's most significant and pressing public health concerns. Not only does smoking cost over $96 billion in public and private health care dollars annually, it is responsible for nearly half a million deaths each year. Moreover, for every tobacco related death, there are 20 individuals who are suffering with a tobacco-related disease. Nevertheless, despite research as well as financial and policy efforts geared towards tobacco prevention and cessation, the rates of smoking have remained stable for the last several years. Nevertheless, especially with regard to youth smokers, there continues to be both a significant need and a significant demand for effective cessation programs. Unfortunately, however, there is limited evidence regarding successful youth smoking cessation programs. Because so few programs have been successful, relatively little is known about the socio-demographic, psychological, and contextual characteristics of those teens who undertake structured cessation programs and how these characteristics combine to influence to cessation success or failure. Lack of such knowledge is important because in order to match interventions with those who are most likely to benefit from such programs, as well as to modify existing treatments for those who fail in established interventions, we must first understand the characteristics of those individuals and programs that succeed and those that fail. The present study seeks to address these issues by conducting extensive higher-order analyses, including structural equation modeling and hierarchical linear modeling, of the largest database of teen smokers undergoing cessation treatment in a single, empirically supported intervention - the American Lung Association's Not On Tobacco (NOT) program. By recognizing and attending to the nested nature teen smoking and teen smoking cessation, it is our hope to connect distinct ecological and individual-level variables that influence smoking cessation; thereby illuminating the complex interplay between individual smokers and both his/her proximal and distal social ecology. The contribution of the present study will be significant because it will be the first to evaluate a large database of adolescents seeking to quit smoking through a single empirically supported structured intervention. The results of the proposed study will help determine the role of individual factors (e.g., smoking history, nicotine dependence) as well as several nested factors, including peer smoking environment, cessation group dynamics, and school, community and state level factors. Such knowledge will be critical in the identification of youth at-risk for treatment failure, as well as the identification of critical contextual and policy factors at the individual, local and state level that may relate to smoking cessation success or failure. Project Narrative The proposed study is an extensive analysis of a multiple levels of influence on teen smoking cessation. The state-of-the-art statistical analyses, including structural equation modeling and hierarchical linear modeling, will help illuminate how individual factors, parental and peer influences and school, county and state factors combine to impact the outcomes of teens seeking to quit smoking through an empirically supported cessation program. The proposed research has relevance to public health and cancer control because of the potential that this research has to guide smoking cessation recruitment, program modification, and school, county and state-wide polices regarding smoking.