Enhancing the Efficacy of a Smoking Quit Line in the Military

提高军队戒烟热线的有效性

• 批准号: 9069969
• 负责人: Robert C Klesges
• 金额: $ 73.15万
• 依托单位: UNIVERSITY OF TENNESSEE HEALTH SCI CTR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9069969
• 关键词: Abstinence; Address; Adopted; Air; Centers for Disease Control and Prevention (U.S.); Cigarette; Coast Guard; Confidence Intervals; Development; Funding; Goals; Health; Health Promotion; Human Resources; Intervention; Literature; Location; Marines; Methods; Military Personnel; Nature; Odds Ratio; Participant; Population; Prevalence; Professional counselor; Randomized; Recruitment Activity; Recycling; Relapse; Research; Services; Smoker; Smoking; South Korea; Standardization; State Government; Surveys; Telephone; Testing; Time; Tobacco; Tobacco use; Trust; Underserved Population; War; Work; acronyms; arm; cigarette smoking; disorder prevention; follow-up; health care availability; high risk; interest; intervention program; nicotine replacement; operation; programs; quitline; reduce tobacco use; smoking cessation; success

DESCRIPTION (provided by applicant): In the cigarette smoking intervention literature, one of the most widely adopted and disseminated interventions are telephone tobacco quit lines (QLs).While QLs are efficacious, cessation rates are modest and relapse is marked. To date, no studies have evaluated methods of re-engaging smokers who call QLs that either fail to quit smoking or relapse. Our survey of QLs serving all 50 states revealed that QLs encourage one of two methods for reengagement for those that have relapsed or who failed to quit on their target quit date: (1) Re- initiate the entire QL intervention (Recycle); or (2) reduce the number of cigarettes per day (i.e., Rate Reduction) with the ultimate goal of quitting. Despite widespread use of these reengagement interventions, no empirical evidence exists supporting either these treatment reengagement strategies in tobacco QLs. The focus of this application is to extend our research with our validated tobacco QL in the military. Our rationale includes the fact that military personnel have among the highest rates of cigarette use in the U.S. Active duty military personnel are at high risk for smoking, but represent an underserved population. Smoking rates among active duty personnel range from 26% to 40%, depending on the service branch. Unique challenges to reducing tobacco use in the military exist, including high personnel mobility, remote locations, and limited healthcare service access. Many efficacious stop-smoking programs in civilian populations do not demonstrate efficacy when evaluated in a military population. In our previous funding period, we have documented that our military-tailored QL was associated with extremely high rates of sustained smoking cessation. Our military proactive QL produced superior cessation rates at a one year follow-up compared to a reactive QL. But similar to civilian QLs, we observed marked decay of sustained cessation rates from the end of treatment to the one year follow-up. An opportunity exists to reengage smokers who relapse or fail to quit by the end of QL treatment. As mentioned above, civilian QLs use Recycling and Rate Reduction as the primary method for treatment reengagement. Unfortunately these methods of reengaging the relapsed/failed to quit smoker have not been systematically evaluated. As such, we propose to randomize participants who relapse or fail to quit by the end of the intervention to either (1) repeating the proactive QL (Recycle); (2) smoking reduction with the goal of eventual cessation (Rate Reduction); or (3) the choice of Recycle or Rate Reduction (Choice). Efficacy will be established by assessing both point prevalence and continuous abstinence at a 12 month follow-up. While QL targeted to the military for ultimate dissemination is needed, our findings should be nonetheless generalizable to all tobacco QLs.

描述（由申请人提供）：在吸烟干预文献中，最广泛和传播的干预措施之一是电话烟草戒烟线（QLS）。虽然QL是有效的，但戒烟率是适度的，并且标记了复发。迄今为止，尚无研究评估重新吸烟者的方法，这些吸烟者称QLS无法戒烟或复发。我们对服务所有50个州的QL的调查表明，QLS鼓励对已经复发或未能在其目标退出日期辞职的人进行重新接触的一种方法之一：（1）重新提出整个QL干预（回收）；或（2）减少每天的香烟数量（即降低降低），以戒烟的最终目标。尽管广泛使用了这些重新参与干预措施，但在烟草QL中，尚无任何支持这些治疗重新接触策略的经验证据。 该申请的重点是通过我们在军队中有效的烟草QL扩展我们的研究。我们的理由包括这样一个事实，即军事人员在美国现役军事人员中使用最高的香烟使用率是吸烟的高风险，但代表了服务不足的人口。现役人员的吸烟率在26％至40％之间，具体取决于服务分支机构。减少军事中烟草使用的独特挑战，包括高人员流动性，偏远地区和有限的医疗保健服务访问权限。在军事人群中评估时，许多有效的停止吸烟计划并未表现出疗效。 在以前的资金期间，我们记录了我们的军事量子QL与持续的戒烟率极高有关。与反应性QL相比，我们的军事积极主动的QL在一年后的随访中产生了较高的戒烟率。但是与平民QL相似，我们观察到从治疗结束到一年的随访，持续停止率的衰减显着。 存在重新接触吸烟者的机会，这些吸烟者在QL治疗结束时复发或不退出。如上所述，平民QLS使用回收利用和降低作为治疗重新接触的主要方法。不幸的是，这些重新接触/未能退出吸烟者的方法尚未系统地评估。因此，我们建议将在干预结束时复发或不退出的参与者随机，以（1）重复主动QL（回收）； （2）减少吸烟，以最终停止（降低速度）的目标；或（3）选择回收或降低（选择）的选择。通过在12个月的随访中评估点的患病率和连续禁欲来确定疗效。 尽管需要针对军队进行最终传播的QL，但我们的发现仍应推广到所有烟草QLS。