Assessment of a Teachable Moment for Smoking Cessation

描述(由申请人提供)：可教时刻(TM)指的是激发健康行为改变的生活事件或转变，如医生就诊、早期发现筛查反馈、怀孕、疾病住院和诊断。TMS指导在某个时间点或在人群中实施尼古丁成瘾治疗，以提高干预接受度和有效性。尽管TM的概念具有强烈的间接吸引力，并对TM实施的干预措施进行了150多项研究，但关于TM对吸烟的影响，特别是对受TM间接影响的人(例如癌症患者的亲属)促进戒烟的影响，很少有调查。确定TMS对戒烟的影响一直很困难，因为过去的研究没有：1)将TM戒烟率与没有经历TM的匹配对照组进行比较；2)检查TM后吸烟的纵向变化；以及3)评估TMS的调节因子和中介因子。为了加强对TMS戒烟作用的了解，我们将进行一项前瞻性观察性研究，采用配对分组设计，评估肺癌诊断是否会增加患者亲属/吸烟配偶参加戒烟计划和戒烟的人数，并减少吸烟。我们将比较参加戒烟计划的人数以及两组吸烟者的戒烟率和吸烟率：1)新诊断的肺癌患者的亲属/配偶，2)患有骨科疾病的患者的亲属/配偶。我们还将评估肺癌诊断与登记、戒烟和吸烟之间的联系的调解人和调解人。主要目的是比较肺癌患者的亲属/配偶与骨科患者的亲属/配偶在戒烟计划、戒烟和吸烟率方面的差异。我们还将探索：1)TMS通过增加对个人风险和积极结果预期的感知，促使强烈的情感反应，以及通过重新定义自我概念和社会角色来影响吸烟的启发式方法；以及2)TM和接触TM的人的特征可能影响TM对吸烟的影响，包括：感知疾病的严重性、亲属和患者之间的亲密性，以及亲属/配偶的应对和归因方式。这项研究可以澄清TM戒烟的概念，阐明TMS的潜在机制，并指导未来基于TM的戒烟干预措施的开发和实施。

DESCRIPTION (provided by applicant): A teachable moment (TM) refers to life events or transitions, such as physician visits, early detection screening feedback, pregnancy, and hospitalization for, and diagnosis of, disease, that inspire health behavior change. TMs have guided the implementation of nicotine addiction treatments at a time-point or with a population to enhance intervention acceptance and efficacy. Despite strong inuitive appeal of the TM concept and over 150 studies of interventions implemented in a TM, there has been little investigation of the influence of TMs for smoking, particularly for promoting smoking cessation among those indirectly affected by a TM (e.g., relatives of cancer patients). Determining the influence of TMs for smoking cessation has been difficult since past studies have not: 1) compared TM quit rates to matched controls not experiencing a TM; 2) examined longitudinal changes in smoking after a TM; and 3) assessed moderators and mediators of TMs. To enhance understanding of TMs for smoking cessation, we will conduct a prospective observational study using a matched-group design to assess whether a lung cancer diagnosis increases enrollment in a smoking cessation program and cessation, and reduces smoking, among the patient's relatives/spouse who smoke. We will compare enrollment in a cessation program and cessation and smoking rates in 2 groups of smokers: 1) relatives/spouses of newly-diagnosed lung cancer patients, and 2) relatives/spouses of patients with an orthopedic condition. We will also assess moderators and mediators of the link between a lung cancer diagnosis and enrollment, cessation, and smoking. The primary aim is to compare relatives/spouses of lung cancer patients to relatives/spouses of orthopedic patients in rates of enrollment in a smoking cessation program, cessation, and smoking. We will also explore: 1) a heuristic that TMs influence smoking by increasing perceptions of personal risk and positive outcome expectancies, prompting strong affective responses, and by redefining self-concept and social role; and 2) characteristics about a TM and the person exposed to the TM that may influence the impact of the TM on smoking, including: perceived seriousness of the illness, closeness between the relative and patient, and the relative/spouse's coping and attribution style. This study could clarify the TM concept for smoking cessation, shed light on the underlying mechanisms of TMs, and guide future development and implementation of TM-based smoking cessation interventions.