Real-Time Patterns of Smoking and Alcohol Use: A Daily Data Analysis

描述（由申请人提供）：吸烟和酒精使用的实时模式：用途：每日数据分析吸烟是美国可预防死亡和残疾的主要原因1 -3。尽管吸烟与癌症相关的发病率和死亡率之间存在密切关系，并且戒烟4-7具有明显的健康益处，但每年戒烟的吸烟者很少8，并且70%-95%的戒烟者在第一年内复发。大量饮酒与吸烟高度共病10，也是癌症相关疾病和死亡的一个重要风险因素11 -13，也与持续吸烟有关， 戒烟的成功率（或尝试率）更低。近一半的问题饮酒者依赖尼古丁14，酒精和烟草的综合影响对增加癌症相关风险具有倍增效应。12，15戒烟的自我效能（SE）是戒烟结果的最重要决定因素之一。然而，SE如何变化的机制还不清楚。原因之一是研究没有考虑到其他可能影响SE和吸烟之间联系的因素，这些因素与吸烟行为特别相关，例如酗酒。拟议的应用程序将通过在84名重度饮酒吸烟者的样本中确定阻碍或促进SE和未来戒烟努力的日常变化因素来解决研究中的这一差距。参与者将使用创新的交互式语音应答（IVR）电话调查，每天两次跟踪他们的吸烟、饮酒和与吸烟相关的SE，持续28天。我们将预测未来戒烟结果的可能性（例如，每天减少吸烟、尝试戒烟和完全戒烟）。迄今为止的研究还没有利用创新方法来捕捉日常因素对戒烟结果的影响，也没有专门关注高风险的重度饮酒吸烟者，尽管他们的癌症相关风险升高。一个经验支持的模型描述了每日SE如何介导每日饮酒和吸烟与未来戒烟结果之间的关联，这对于制定有效的戒烟干预措施至关重要。该R 03与美国国家癌症研究所最近的倡议一致：（a）使用创新方法来识别影响癌症相关风险的行为，这些行为可能成为新治疗的目标;（B）减少烟草使用和吸烟流行率;（c）了解合并症对癌症相关风险的影响;以及（c）培养新一代癌症研究人员16 -19。R 03将为在这些领域推动该领域的发展提供坚实的基础，并开始回答许多关于高危人群如何启动和维持癌症相关风险行为变化的问题。这项研究的结果将具有重要的长期临床和公共卫生意义，通过针对大量饮酒吸烟者的独特需求制定有针对性的戒烟干预措施，降低癌症相关风险和疾病的总体患病率。

DESCRIPTION (provided by applicant): Real-time patterns of smoking and alcohol use: A daily data analysis Cigarette smoking is the leading cause of preventable death and disability in the United States1-3. Despite the strong relationship between smoking and cancer-related morbidity and mortality and the noted health benefits of quitting 4-7, very few smokers quit every year 8, and between 70%-95% of those who do quit relapse within the first year 9. Heavy drinking, which is highly co-morbid with cigarette smoking 10, also represents a significant risk factor for cancer-related illness and mortality11-13, and is also implicated in persistent smoking, and less success (or attempts) at quitting smoking. Nearly half of all problem drinkers are nicotine dependent 14, and the combined influence of alcohol and tobacco has a multiplicative effect on increasing cancer-related risk.12,15 Self-efficacy (SE) to abstain from smoking is one of the most important determinants of smoking cessation outcomes. However, the mechanism of how SE changes is not well understood. One reason is that studies have failed to take into account other factors that may influence associations between SE and smoking that are particularly relevant to smoking behavior, such as heavy drinking. The proposed application will address this gap in the research by identifying daily changing factors that impede or promote SE and future smoking cessation efforts in a sample of 84 heavy drinking smokers. Participants will track their smoking, alcohol consumption, and SE related to smoking twice a day for 28 days using innovative interactive voice response (IVR) telephone surveys. We will predict the likelihood of future smoking cessation outcomes (e.g., reduced cigarettes per day, cessation attempts, and complete abstinence) at 1- and 6-months follow-up from these daily factors. Research to date has not taken advantage of innovative methods that capture the impact of daily factors on smoking cessation outcomes, nor have they focused specifically on high-risk heavy drinking smokers, despite their elevated cancer-related risk. An empirically supported model describing how daily SE mediates the association between daily drinking and smoking to future cessation outcomes is crucial for developing effective smoking cessation interventions. This R03 is consistent with recent initiatives at the National Cancer Institute to: (a) use innovative approaches to identify behaviors that impact cancer-related risk that could be targeted in new treatments; (b) reduce tobacco use and the prevalence of cigarette smoking; (c) understand the impact of co-morbid conditions on cancer-related risk; and (c) prepare a new generation of investigators for cancer research16-19. This R03 would provide a strong basis for moving the field forward in these areas and to begin to answer many of the questions that remain about how high-risk groups initiate and maintain changes in cancer-related risk behaviors. Findings from this study will have important long-term clinical and public health significance in decreasing the overall prevalence of cancer-related risk and illness by developing targeted cessation interventions for the unique needs of heavy drinking smokers.