A Text-Based Scheduled Reduction Intervention for Smokeless Tobacco Cessation

项目摘要 在农村和医疗服务不足的人群中，无烟烟草（咀嚼或蘸烟）的使用仍然很普遍， 导致与烟草有关的癌症和慢性病的发病率增加。然而，服务不足的烟草使用者 想要戒烟的人几乎没有创新的干预措施。这是一个重要的机会， 解决这一群体的健康差距。定期逐步减少（SGR）可能是一种有效的方法。 帮助无烟烟草使用者戒烟。SGR解决常见的戒烟挑战， 无烟烟草使用者包括强烈的基于线索的使用成分和强烈的戒断 症状SGR方法在这一烟草使用者人群中的研究最少，代表了一种 创新领域的新方向。SGR包括通过以下方式逐渐减少无烟烟草的使用 根据个人定制的时间表延长使用间隔。SGR帮助无烟烟草使用者 学会避免咀嚼/蘸取环境线索，按照时间表，逐渐减少 他们的使用。通过短信提供SGR干预措施是一种创新的方式，以增加这一影响力。 对得不到充分服务的人群进行戒烟干预。因此，我们建议进行一项随机临床试验， 评价SGR干预（SGR干预加上基于文本的支持消息）与对照的有效性 减少无烟烟草使用的干预措施（基于文本的支持信息）。SGR组（N=250） 将收到为期六周的SGR计划和基于文本的支持消息。对照组（N=250）将 接收基于文本的支持消息。主要结果将是自我报告的无烟烟草戒烟， 6个月我们还将测试与支持消息相比，基于文本的SGR干预的有效性 仅研究6个月期间戒断、渴求、自我调节和克制的变化，并探索 退缩、渴求、自我调节和克制的变化是否介导了干预对自我的影响， 据报告，干预后6个月停止。这项研究的结果可以广泛传播，以帮助 无烟烟草使用者戒烟的最终目标是增加获得有效戒烟干预措施的机会 消除癌症健康差异。

Project Summary Smokeless tobacco (chew or dip) use remains prevalent in rural and medically underserved populations, leading to increased rates of tobacco-related cancers and chronic disease. Yet, underserved tobacco users who want to quit have access to few innovative interventions. This is a significant missed opportunity to address health disparities in this group. Scheduled Gradual Reduction (SGR) may be an effective intervention to help smokeless tobacco users quit. SGR addresses common cessation challenges faced by smokeless tobacco users including the strong cue-based component of use and strong withdrawal symptoms. The SGR method been minimally studied in this population of tobacco users and represents an innovative new direction in the field. SGR involves gradually tapering smokeless tobacco use through lengthening use intervals based on an individually tailored schedule. SGR helps smokeless tobacco users learn to refrain from chew/dips that are in environmental cues by following the schedule and gradually reducing their use. Delivering SGR interventions via text messaging is an innovative way to increase the reach of this cessation intervention in underserved populations. Therefore, we propose a randomized clinical trial to evaluate the efficacy of a SGR Intervention (SGR intervention plus text-based support messages) vs. control intervention (text-based support messages) in decreasing smokeless tobacco use. The SGR group (N=250) will receive a six-week SGR program and text-based support messages. The control group (N=250) will receive text-based support messages. The primary outcome will be self-report smokeless tobacco cessation at 6 months. We will also test the efficacy of the text-based SGR intervention compared to support messages only on changes in withdrawal, craving, self-regulation and restraint across the 6-month period and explore whether changes in withdrawal, craving, self-regulation and restraint mediate intervention effects on self- reported cessation at 6 months post-intervention. Results of this study can be disseminated broadly to help smokeless tobacco users quit with the ultimate goal of increasing access to efficacious cessation interventions and eliminating cancer health disparities.