Using Ecolog. Momentary Assess. To Examine Pain & Smoking In Head & Neck Cancer P

癌症确诊后继续吸烟与治疗效果差和总生存率低有关。然而，在得知他们的癌症诊断后，许多吸烟的患者继续使用烟草。即使在戒烟的患者中，许多人也未能保持长期的禁欲。因此，研究癌症患者的吸烟动机和戒烟失败的机制是非常重要的。本研究的目的是探讨头颈部癌症患者的疼痛、吸烟动机与戒烟之间的关系。该项目的具体目标是：1）检查疼痛与吸烟相关变量之间的关系（例如，负性情感、冲动、自我效能），2）确定尼古丁对吸烟的头颈癌患者疼痛的镇痛作用，3）确定戒烟对头颈癌患者疼痛的影响。该项目是一项自然主义研究，使用生态瞬时评估（EMA）来评估在4周监测期内吸烟的头颈癌患者的疼痛，吸烟和其他吸烟相关变量。EMA是指一种使用掌上电脑（PPC）来测量人类在自然环境中发生行为的方法。参与者将包括40名吸烟的头颈癌患者，他们被转介到烟草治疗计划进行戒烟治疗。所有受试者将参加1次基线和2次研究访视。在基线访视期间，将根据入选和排除标准筛选潜在受试者。合格的参与者将完成一系列问卷调查，旨在测量吸烟的易感性变量，包括情感脆弱性，尼古丁依赖，持久的应对方式，自我效能风格，持久的癌症相关症状和感知压力水平。他们将获得PPC并接受使用培训。将指导受试者在抗癌治疗开始前2周开始使用PPC进行EMA监测，并持续至抗癌治疗开始后2周。在为期4周的EMA监测期间，将要求受试者完成4种类型的评估（每日日记、诱惑、吸烟和失效），包括核心（例如，疼痛、情感、吸烟冲动、禁欲自我效能）和独特的（例如，每日服用止痛药）项目。受试者将在首次研究访视期间返还PPC，该访视将安排在抗癌治疗开始后约2周。第二次也是最后一次研究访视将在受试者开始抗癌治疗后约3个月进行。在两次访视时，受试者将完成与基线访视期间相同的一组问卷。此外，研究人员将评估受试者的戒烟情况，并进行呼吸和唾液可替宁测试，以确认自我报告的戒烟情况。

Continued smoking after cancer has been diagnosed is associated with a poor treatment outcome and a low overall survival rate. However, on learning about their cancer diagnosis, many patients who smoke continue to use tobacco. Even among patients who quit, many fail to maintain long-term abstinence. Therefore, it is important for researchers to study the mechanisms that underlie smoking motivation and abstinence failure in cancer patients. The objective of this proposed project is to study the relationships between pain, smoking motivation, and smoking cessation among patients with head and neck cancer. The specific aims of this project are to 1) examine the relationship between pain and smoking-related variables (e.g., negative affect, urge, self- efficacy) in patients with head and neck cancer who smoke, 2) identify nicotine's antinociceptive effect on pain in patients with head and neck cancer who smoke, and 3) determine the effect of smoking abstinence on pain in patients with head and neck cancer. The proposed project is a naturalistic study that uses ecological momentary assessment (EMA) to assess pain, cigarette use, and other smoking-related variables in head and neck cancer patients who smoke during a 4-week monitoring period. EMA refers to a method that uses a palmtop personal computer (PPC) to measure human behaviors at the moment of their occurrence in natural environments. Participants will include 40 head and neck cancer patients who smoke and are referred to the Tobacco Treatment Program for smoking cessation treatment. All participants will attend 1 baseline and 2 study visits. During the baseline visit, prospective participants will be screened for inclusion and exclusion criteria. Eligible participants will complete a battery of questionnaires that is designed to measure predispositions variables of smoking that include affective vulnerability, nicotine dependence, enduring coping style, self-efficacy style, enduring cancer-related symptoms, and perceived stress level. They will be given a PPC and trained in its use. Participants will be instructed to start using the PPC for EMA monitoring 2 weeks before their anticancer treatment begins and to continue until 2 weeks after the beginning of their anticancer treatment. During this 4-week EMA monitoring period, participants will be asked to complete 4 types of assessments (daily diary, temptation, smoking, and lapse) that include both core (e.g., pain, affect, urge to smoke, abstinence self-efficacy) and unique (e.g., daily intake of pain medications) items. Participants will return the PPC during the first study visit, which will be scheduled approximately 2 weeks after the beginning of their anticancer treatment. The second and final study visit will take place at approximately 3 months after the beginning of the participants' anticancer treatment. At both visits, participants will complete the same battery of questionnaire as they will during the baseline visit. Furthermore, study personnel will assess participants' smoking abstinence and administer breath and saliva cotinine tests to confirm self-reported abstinence.