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

描述（由申请人提供）：物质使用障碍（SUD）治疗个体的吸烟患病率保持在约70%或更高，即使一般人群的吸烟率已降至20.6%。在美国，接受SUD治疗的吸烟者在烟草发病率和死亡率负担中占特别大的比例，最终更有可能死于烟草使用而不是其他物质使用。然而，在SUD治疗中戒烟服务的可用性仍然相对罕见。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，可以很容易地整合到SUD治疗计划，以激励吸烟患者戒烟。本申请的总体目标是 实现这一长期目标的第一步是充分开发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，并获得支持干预措施功效的初步数据。这将通过追求三个具体目标来完成B：1）开发并进行初步的试点测试（n=20）的简短，基于计算机的干预，旨在激励吸烟者在SUD治疗中戒烟（TIME-TQ;平板电脑干预，以激励参与烟草戒烟线使用），并开发和试点测试基于计算机的，时间匹配的控制干预（CON），2）对60名接受SUD治疗的吸烟者进行初步随机对照试验（RCT），比较TIME-TQ与CON，预测TIME-TQ相对于CON将导致1个月和3个月随访时的准备程度增加，烟草治疗参与率更高，戒烟尝试更多，7天时点戒烟率更高。还将检查3个月随访期间的物质使用结果，3）检查TIME-TQ对计算机会话期间关键机制的影响及其与1个月和3个月随访时烟草治疗参与和吸烟结果的关联。拟议的研究具有创新性，因为：1）之前没有研究在SUD治疗环境中实施针对烟草使用的基于计算机的动机干预，2）本申请中提出的TIME-TQ干预专注于促进烟草治疗参与而不是戒烟本身，以及3）之前没有研究试图将SUD治疗中的吸烟者与免费烟草戒烟热线联系起来，一种有效且容易获得的资源。预计该项目产生的TIME-TQ干预措施将具有广泛的潜力， 如果能够有效地激励吸烟者在SUD治疗中使用戒烟线，将对减少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措施的科学知识以增加戒烟线的使用产生重大的总体影响。

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.