Assessment of a Teachable Moment for Smoking Cessation

描述（由申请人提供）：可教时刻（TM）是指生活事件或转变，如医生访问，早期检测筛选反馈，怀孕，住院治疗和诊断，疾病，激发健康行为改变。TM指导了在某个时间点或人群中实施尼古丁成瘾治疗，以提高干预的接受程度和有效性。尽管TM概念具有强烈的直觉吸引力，并且有超过150项关于在TM中实施干预措施的研究，但很少有关于TM对吸烟的影响的研究，特别是在间接受TM影响的人群中促进戒烟（例如，癌症患者家属）。确定TM对戒烟的影响一直很困难，因为过去的研究没有：1）比较TM戒烟率与未经历TM的匹配对照组; 2）检查TM后吸烟的纵向变化; 3）评估TM的调节剂和介质。为了加强对TM戒烟的理解，我们将使用配对组设计进行一项前瞻性观察性研究，以评估肺癌诊断是否增加了戒烟计划的入组人数，并在吸烟的患者亲属/配偶中戒烟和减少吸烟。我们将比较两组吸烟者的戒烟计划入组率和戒烟率：1）新诊断肺癌患者的亲属/配偶，2）骨科疾病患者的亲属/配偶。我们还将评估肺癌诊断与入组、戒烟和吸烟之间联系的调节者和介导者。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、戒烟和吸烟的入组率。我们还将探索：1）一种启发式的方法，即TM通过增加对个人风险和积极结果预期的感知，促进强烈的情感反应，以及通过重新定义自我概念和社会角色来影响吸烟;以及2）关于TM和接触TM的人的特征，这些特征可能影响TM对吸烟的影响，包括：疾病的严重性，亲属和患者之间的亲密程度，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，揭示TM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.