Brief computer intervention to motivate quitline use for smokers in SUD treatment

描述(申请人提供)：在接受物质使用障碍(SUD)治疗的个人中，吸烟的流行率保持在约70%或更高，尽管普通人群的吸烟率已下降至20.6%。在美国，接受SUD治疗的吸烟者承担着特别大比例的烟草发病率和死亡负担，最终比起其他物质的使用，他们更有可能死于烟草使用。然而，在SUD治疗中提供戒烟服务的情况仍然相对少见。这项研究计划的长期目标是传播一种有效的、简短的基于计算机的干预措施，这种干预措施可以很容易地整合到SUD治疗计划中，以激励吸烟患者使用烟草奎宁。此应用程序的总体目标是 实现这一长期目标的第一步是充分发展这一基于计算机的干预措施，根据初步试点和反馈对其进行修改，以确保其可行性和可接受性，并获得支持干预效果的初步数据。这将通过追求三个具体目标来实现：1)开发和进行简短的、基于计算机的干预的初步试点测试(n=20)，旨在促进吸烟者在SUD治疗中使用烟草戒毒碱(Time-TQ；2)开展一项以计算机为基础的时间匹配对照干预(CON)，对60名接受SUD治疗的吸烟者进行初步的随机对照试验(RCT)，比较时间-TQ与CON，预测在1个月和3个月的随访中，时间-TQ相对于CON将导致更高的戒烟准备、更高的烟草治疗参与率、更多的戒烟尝试和更高的7天时点戒烟率。还将检查在3个月随访期内的物质使用结果，以及3)检查时间-TQ对计算机会话期间关键机制的影响，以及它们与1个月和3个月随访期的烟草治疗参与度和吸烟结果的关系。这项研究的创新之处在于：1)以前的研究没有针对SUD治疗环境中的烟草使用实施基于计算机的动机干预，2)本申请中提出的时间-质量干预本身侧重于促进烟草治疗的参与度，而不是戒烟本身，以及3)以前的研究没有试图将SUD治疗中的吸烟者与免费烟草戒烟线联系起来，这是一种有效和容易获得的资源。预计由该项目产生的时间-时间干预将具有广泛的 如果能有效地激励吸烟者在SUD治疗中使用烟草奎宁，将对降低吸烟相关的发病率和死亡率以及促进关于简短的、基于计算机的烟草干预以增加奎宁使用的科学知识产生重大的整体影响。

DESCRIPTION (provided by applicant): The prevalence of cigarette smoking among individuals in substance use disorder (SUD) treatment remains at about 70% or higher even as the smoking rate in the general population has declined to 20.6%. Smokers in SUD treatment bear an especially large proportion of the tobacco morbidity and mortality burden in the U.S. and ultimately are more likely to die from their tobacco use than from their other substance use. Yet the availability of smoking cessation services in SUD treatment remains relatively uncommon. The long-term goal of this program of research is to disseminate an effective, brief computer-based intervention that can be readily integrated into SUD treatment programs to motivate tobacco quitline use in patients who smoke. The overall objective of this application, which is the first step in the attainment of this long-term goal, is to fully develop this computer-based intervention, modify it based on initial piloting and feedback to insure its feasibility and acceptability, and obtain preliminary data supporting the efficacy of the intervention. This will b accomplished by pursuing three specific aims: 1) to develop and conduct preliminary pilot testing (n=20) of a brief, computer-based intervention intended to motivate tobacco quitline use among cigarette smokers in SUD treatment (TIME-TQ; Tablet computer Intervention to Motivate Engagement in Tobacco Quitline use) and to develop and pilot test a computer-based, time matched control intervention (CON), 2) to conduct a preliminary randomized controlled trial (RCT) with 60 smokers in SUD treatment, comparing TIME-TQ vs. CON, with predictions that TIME-TQ relative to CON will result in increased readiness, higher rates of tobacco treatment engagement, more quit smoking attempts and higher rates of 7-day point prevalence abstinence rates at 1- and 3-month follow-ups. Substance use outcomes over the course of the 3-month follow-up period will also be examined, and 3) to examine TIME-TQ's effects on key mechanisms during the computer session and their associations with tobacco treatment engagement and smoking outcomes at 1- and 3-month follow-ups. The research proposed is innovative in that: 1) no previous studies have implemented a computer-based motivational intervention targeting tobacco use in an SUD treatment setting, 2) the TIME-TQ intervention proposed in this application is focused on promoting tobacco treatment engagement rather than smoking cessation, per se, and 3) no previous studies have attempted to link smokers in SUD treatment with free tobacco quitlines, an efficacious and readily available resource. It is anticipated that the TIME-TQ intervention resulting from this project will have potential for broad reach to SUD treatment programs and if effective in motivating tobacco quitline use among smokers in SUD treatment, will have significant overall impact in reducing smoking-related morbidity and mortality and in advancing scientific knowledge regarding brief, computer-based tobacco interventions to increase quitline utilization.