Natural History of Smoking & Quitting: Longterm Outcomes

迄今为止，除了戒烟率和最终疾病结果之外，烟草科学几乎没有揭示有关持续吸烟和戒烟的自然历史的信息。追踪戒烟成功或失败的吸烟者的命运有望在重要的生理和心理社会领域发现戒烟的新关联，并可能揭示重要结果（例如动脉粥样硬化、生活质量改善[QOL]）发生的机制。长期跟踪吸烟行为的纵向方法也可以识别导致晚期复发的因素。这项研究将对 360 名成功戒烟者和 540 名继续吸烟者进行为期三年的戒烟尝试追踪，以追踪吸烟行为、动脉粥样硬化 进展、精神症状、生活质量、社交网络、体力活动、饮酒/滥用和其他变量。分析将在这些变量上对比戒烟者和继续吸烟者。医学和心理社会结构将通过多个指标来衡量以获得收敛效度。我们假设成功戒烟与动脉粥样硬化的阻止、精神疾病诊断和症状的减少、生活质量的提高以及酒精摄入量的减少有关。我们还预计一些戒烟者（例如，体重增加相当多的人）会经历负面结果，例如高血脂、高血压和生活质量下降。我们将探讨个体差异（包括遗传差异）与戒烟相关因素和中介变量的关系。分析还将测试社会因素（例如，接触吸烟者、社会支持）和饮酒对戒烟一年后复发的影响。本研究收集的数据应该揭示并增强我们对积极因素的理解 戒烟对生理和心理社会领域的影响。对吸烟者进行有关这些好处的教育可能会激励更多吸烟者戒烟。此外，发现与戒烟相关的不良事件可能有助于吸烟者避免此类结果，并确定降低风险干预措施的目标，包括预防晚期复发的干预措施。

To date, tobacco science has revealed little about the natural history of continued smoking and quitting, apart from abstinence rates and ultimate disease outcomes. Tracking the fates of smokers who succeed or fail in a quitattempt promises to uncover new correlates of cessation in important physiological and psychosocial domains and may reveal the mechanisms by which important outcomes (e.g., atherosclerosis, improved quality of life [QOL]) occur. A longitudinal approach that tracks smoking behavior over an extended period may also identify factors that precipitate late relapse. This study will follow 360 successful quitters and 540 continuing smokers for three years after a quit attempt to track smoking behavior, atherosclerotic progression, psychiatric symptoms, QOL, social networks, physical activity, alcohol use/abuse, and other variables. Analyses will contrast quitters and continuing smokers on these variables. Medical and psychosocial constructs will be measured by multiple indicators to obtain convergent validity. We hypothesize that successful cessation will be associated with arrest of atherosclerosis, reduced psychiatric diagnoses and symptoms, enhanced QOL, and reduced alcohol intake. We also expect that some quitters (e.g., those who gain considerable weight) will experience negative outcomes, such as hypedipidemia, hypertension, and reduced QOL. We will explore relations of individual differences, including genetic differences, with quitting correlates and mediational variables. Analyses will also test the ability of social factors (e.g., exposure to smokers, social support) and alcohol use to account for relapses occurring after one year of abstinence. Data gathered in this study should reveal and enhance our understanding of positive effects of quitting in physiological and psychosocial domains. Educating smokers about such benefits may motivate more smokers to quit. Additionally, uncovering adverse events associated with cessation may help smokers avoid such outcomes and identify targets for risk-reduction interventions, including interventions to prevent late relapse.