Mobile Mindfulness for Smoking Cessation

描述（由申请人提供）：吸烟是美国最主要的可预防的死亡原因。许多因素导致了戒烟的挑战，包括联想学习过程，其中负面影响和压力诱导的渴望导致吸烟，以及每天多次被吸烟行为强化的学习反应。已经开发了许多行为干预措施来治疗吸烟，但成功率仍然很低。我们最近发现，以团体为基础的正念训练，专门针对压力、渴望和习得性反应，与其他行为治疗（如美国肺科协会的“戒烟自由”）相比，戒断率翻了一番。我们还发现了正念训练（MT）的潜在机制：渴望和吸烟之间的联系脱钩。然而，临床以小组为基础的治疗是昂贵的，并且由于治疗师经验的变化和对手动培训的依从性难以标准化。手机应用程序的最新进展导致了基于应用程序的戒烟干预措施，可以降低成本并优化标准化交付。为了提高MT的交付，我们已经将我们的手动吸烟MT翻译成智能手机应用程序（渴望戒烟，C2Q）。此外，我们还与一个在线社区配对，该社区可以提供同伴支持和专家指导。在本研究中，the Primary Aim将评估移动正念训练（C2Q）的效果。为了实现这一目标，1200名吸烟者将随机接受C2Q，即美国国家癌症研究所的NCIQuitPal。主要终点将是治疗开始后6个月自我报告的7天点流行戒断。次要目标1是评估C2Q项目的短期效果。次要终点将包括治疗开始后3个月的7天点患病率戒断。次要目标2将确定C2Q使用与戒烟之间的关系在3个月和6个月。C2Q计划的使用，通过(1)完成的模块数量，(2)完成的非正式正念练习的数量，(3)访问在线社区的次数来衡量，将用于回归分析，以确定他们预测C2Q组吸烟的程度。拟议的研究为社会提供了潜在的好处。首先，本研究将测试一种具有成本效益的戒烟治疗方法C2Q的疗效。其次，这项研究将测试假设的预测结果，这将提高我们对戒烟的理解和治疗。

DESCRIPTION (provided by applicant): Smoking is the leading preventable cause of death in the U.S. A number of factor contribute to the challenge of quitting smoking, including the associative learning process whereby negative affect and stress-induced craving lead to smoking, and learned responses that are reinforced multiple times daily by smoking behavior. Many behavioral interventions have been developed to treat smoking, but success rates remain low. We have recently found that group-based mindfulness training, which specifically targets stress, craving and the learned responses, doubles abstinence rates compared to other behavioral treatments such as the American Lung Association's Freedom From Smoking. We have also found potential mechanisms for mindfulness training (MT): the decoupling of the link between craving and smoking. However, clinic group-based treatments are expensive and delivery is difficult to standardize due to variability in therapist experience and adherence to manualized training. Recent advances in mobile-phone applications have led to app-based interventions for smoking cessation that can reduce costs and optimize standardized delivery. To enhance delivery of MT, we have translated our manualized MT for smoking into a smartphone application (Craving To Quit, C2Q). Further, we have paired this with an online community, which can provide peer support and expert guidance. In the proposed study, The Primary Aim will assess the efficacy of mobile mindfulness training (C2Q). To achieve this, 1200 smokers will be randomized to receive C2Q, or The National Cancer Institute's NCIQuitPal. The primary endpoint will be self-reported 7-day point prevalence abstinence at 6 months after treatment initiation. Secondary Aim 1 will be to assess the short-term efficacy of the C2Q program. Secondary endpoints will include 7-day point prevalence abstinence at 3 months after treatment initiation. Secondary Aim 2 will be to determine the relationship between C2Q usage and tobacco abstinence at 3 and 6 months. C2Q program usage, measured by (1) the number of modules completed, (2) the amount of informal mindfulness practice completed, and (3) the number of visits to the online community will be used in regression analyses to determine the degree to which they predict smoking in the C2Q group. The proposed study provides potential benefits for society. First, this study will test the efficacy of a cost-effective treatment for smoking cessation, C2Q. Second, this study will test hypothesized predictors of outcomes which will improve our understanding and treatment of smoking cessation.