Natural History of Smoking & Quitting: Longterm Outcomes

到目前为止，烟草科学除了禁烟率和最终疾病后果外，几乎没有揭示持续吸烟和戒烟的自然历史。跟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，并可能揭示发生重要结果(例如动脉粥样硬化、生活质量改善[QOL])的机制。一种跟踪长期吸烟行为的纵向方法也可能确定导致晚期复发的因素。这项研究将对360名成功戒烟的人和540名戒烟后继续吸烟的人进行为期三年的跟踪调查，以跟踪吸烟行为和动脉粥样硬化 疾病进展、精神症状、生活质量、社交网络、体力活动、酗酒/滥用，以及其他变量。分析将对比戒烟者和持续吸烟者在这些变量上的差异。医学和心理社会结构将由多个指标衡量，以获得趋同的效度。我们假设，成功戒烟将与动脉粥样硬化的停止、精神诊断和症状的减少、生活质量的提高和酒精摄入量的减少相关。我们还预计，一些戒烟者(例如，体重增加相当多的人)将经历负面后果，如高脂血症、高血压和生活质量下降。我们将探索个体差异，包括遗传差异，与退出相关因素和中介变量的关系。分析还将测试社会因素(例如，与吸烟者的接触、社会支持)和饮酒对戒烟一年后复发的解释能力。在这项研究中收集的数据应该揭示和加强我们对积极的理解 戒烟对生理和心理社会领域的影响。教育吸烟者了解这些好处可能会促使更多的吸烟者戒烟。此外，揭示与戒烟相关的不良事件可能有助于吸烟者避免这种结果，并确定降低风险干预的目标，包括防止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.