Smoking Cessation Intervention for Diabetic Patients

描述（由申请人提供）：2型糖尿病患者的吸烟率与一般人群相似，吸烟对健康的影响在糖尿病吸烟者中尤为严重。事实上，吸烟和糖尿病对死亡率似乎有协同作用。然而，尽管有报告强调了这项工作的重要性，但很少有研究来开发和测试针对糖尿病患者需求的戒烟干预措施。现存的少量研究得出了不同的结果。以痛苦耐受（DT）为重点的、基于接受的干预措施已证明对戒烟有效，并且越来越多的人支持这些干预措施在糖尿病患者中的概念模型。该研究项目的长期目标是通过开发和建立针对2型糖尿病患者的DT戒烟干预措施的有效性，改善该人群的戒烟治疗。此外，我们寻求推进尼古丁戒断，负面影响，痛苦耐受和糖尿病患者戒烟结果之间关系的知识。在本申请中，我们提出开发一种定制的DT干预，以满足患有2型糖尿病的吸烟者的需求。在该项目的第一阶段，我们将开发并试点18名患者的干预措施。在该项目的第二阶段，我们将对54名患者进行一项初步的随机试验，以检查DT干预相对于标准戒烟治疗（ST）的疗效，ST等同于治疗师接触时间。这两种情况的患者将接受尼古丁透皮贴剂。我们预计，相对于ST条件，随机分配至DT条件的患者戒烟的可能性增加，戒烟和复吸的潜伏期增加。如果这种干预的有效性可以在本试验和随后的大规模随机对照试验中确定，糖尿病吸烟者将有更好的戒烟治疗选择。鉴于这一领域现有工作的缺乏，糖尿病患者吸烟的发病率和死亡率显著升高，美国糖尿病发病率迅速上升，近年来吸烟率明显稳定。 公共卫生相关性：拟议的研究旨在为2型糖尿病吸烟者开发和测试戒烟干预措施。鉴于糖尿病患者吸烟对健康的负面影响风险增加，这是一个值得关注的重要人群。如果成功，这种干预可以帮助糖尿病患者成功戒烟，活得更长，更健康。

DESCRIPTION (provided by applicant): Individuals with Type 2 diabetes smoke at rates similar to those found in the general population, and the health consequences of smoking are particularly severe among smokers with diabetes. In fact, there appears to be a synergistic effect between smoking and diabetes on mortality. However, despite reports that highlight the importance of this work, a paucity of studies have been conducted to develop and test smoking cessation interventions tailored to meet the needs of individuals with diabetes. The small number of extant studies have yielded mixed results. Distress tolerance (DT) focused, acceptance-based interventions have demonstrated efficacy for smoking cessation, and there is increasing support for the conceptual model underlying these interventions among individuals with diabetes. The long-term objective of this research program is to improve smoking cessation treatment for individuals with Type 2 diabetes by developing and establishing the efficacy of a DT smoking cessation intervention tailored to this population. Furthermore, we seek to advance knowledge of the relationships among nicotine withdrawal, negative affect, distress tolerance, and smoking cessation outcomes among individuals with diabetes. In the present application, we propose to develop a DT intervention tailored to meet the needs of smokers with Type 2 diabetes. In the first phase of this project, we will develop and pilot the intervention with 18 patients. In the second phase of the project, we will conduct a preliminary, randomized trial with 54 patients to examine the efficacy of the DT intervention relative to a standard smoking cessation treatment (ST) that equates for therapist contact time. Patients in both conditions will receive the transdermal nicotine patch. We expect that, relative to the ST condition, patients randomized to the DT condition will have increased likelihood of smoking abstinence and increased latency to both smoking lapse and relapse. If the efficacy of this intervention can be established in this trial and in subsequent large scale randomized controlled trials, smokers with diabetes will have improved smoking cessation treatment options. The need for this work is great given the paucity of extant work in this area, the significantly heightened risk of morbidity and mortality from smoking among diabetic patients, the rapidly increasing rate of diabetes in the U.S., and an apparent stabilization of the smoking rate in recent years. PUBLIC HEALTH RELEVANCE: The proposed study aims to develop and test a smoking cessation intervention for smokers with Type 2 diabetes. This is an important population on which to focus given the increased risk of negative health effects from smoking among individuals with diabetes. If successful, this intervention could help individuals with diabetes to successfully quit smoking and to live longer, healthier lives.