Natural History of Smoking & Quitting: Longterm Outcomes

迄今为止，除了戒烟率和最终疾病结果外，烟草科学对持续吸烟和戒烟的自然历史知之甚少。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社会心理领域发现戒烟的新相关性，并可能揭示重要结果（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确定导致晚期复发的因素。这项研究将对360名成功戒烟者和540名戒烟者进行为期三年的跟踪调查，追踪他们的吸烟行为和动脉粥样硬化

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.