Spirometry to Motivate Quit-Smoking Attempts: Message Development and Testing

描述（由申请人提供）：吸烟是工业化国家可预防疾病的主要原因，特别是心血管和呼吸系统疾病以及癌症。2000年，美国卫生与公众服务部发布了一份基于证据的治疗烟草使用和依赖的临床实践指南，其中指出，吸烟但不愿意戒烟的患者应该接受干预，以增加他们戒烟的动力。列出的动机之一是强调吸烟的风险。这些风险之一是肺功能下降，通过肺活量测定法测量。然而，肺量测定法促进戒烟的证据有限。美国卫生保健研究和质量局（AHRQ）最近得出结论，现有证据不支持在初级保健环境中使用肺量测定法来提高戒烟率。尽管如此，在认识到这一工具的潜在重要性，AHRQ列出了随机对照试验的需要，以确定肺功能测定在戒烟中的作用，作为未来研究的优先事项。在进行这样的对照试验之前，我们需要了解为什么肺活量测定法没有令人信服地增强戒烟效果。我们认为，肺量测定法在这方面失败的主要原因是，在戒烟的重要性的背景下，测量的意义没有有效地传达给吸烟的患者。为了验证这一假设，我们设计了这一建议，以开发一种增强的[肺活量测定干预，包括动机信息和随访信]，然后测试这种[干预]对戒烟尝试率的影响。我们假设，与通过标准干预提供这些结果相比，通过增强的[肺量测定干预]向当前吸烟者提供肺功能知识将增加戒烟尝试率。我们的三个具体目标是：1）使用行为和沟通理论的原则开发关于肺量测定的增强激励信息; 2）确定通过增强的[肺量测定干预]向当前吸烟者提供肺量测定结果对戒烟尝试率的影响; 3）确定哪些临床特征与戒烟尝试相关，并确定肺量测定在提高戒烟尝试率方面的有效性的障碍。这些数据将为今后开展肺量测定法对戒烟有效性的大型临床试验提供框架。吸烟是世界上与癌症有关的死亡的主要原因。因此，戒烟是癌症控制中最重要的行为干预。该项目将确定测量吸烟者的肺功能并使用强有力的激励策略将结果传递给他们是否会增加他们尝试戒烟的可能性。如果是这样，那么这种策略可以用于大规模研究，以确定肺功能结果是否能有效地让人们戒烟。

DESCRIPTION (provided by applicant): Smoking is a leading cause of preventable disease in industrialized countries, especially cardiovascular and respiratory illness, and cancer. In 2000, the US Department of Health and Human Services issued an evidenced-based Clinical Practice Guideline on Treating Tobacco Use and Dependence that states that patients who smoke, but are unwilling to quit, should receive an intervention that increases their motivation to quit. Among the motivations listed is highlighting the risks of cigarette smoking. One of these risks is decreased lung function as measured by spirometry. However, the evidence that spirometry enhances smoking cessation is limited. The Agency for Healthcare Research and Quality (AHRQ) recently concluded that the available evidence does not support the use of spirometry in the primary care setting in order to improve smoking cessation rates. Nonetheless, in recognition of the potential importance of this tool, the AHRQ lists the need for randomized controlled trials to determine the role of spirometry in smoking cessation as a priority of future research. Before such controlled trials can take place, we need to understand why spirometry has not been shown to convincingly enhance smoking cessation. We believe that the primary reason spirometry has failed in this regard is because the meaning of the measurement in the context of the importance of smoking cessation is not effectively communicated to the patient who smokes. To test this hypothesis, we have designed this proposal to develop an enhanced [spirometry intervention, to include a motivational message and follow-up letter], and then test the impact of this [intevention] on the quit attempt rate. We hypothesize that providing knowledge of lung function to current smokers through an enhanced [spirometry intervention] will increase the quit attempt rate compared to delivery of these results through a standard [intervention]. Our 3 Specific Aims are: 1) To develop an enhanced motivational message about spirometry using principles of behavioral and communication theory; 2) To determine the effect of delivering spirometry results to current smokers through an enhanced [spirometry intervention] on the quit attempt rate; 3) To determine which clinical characteristics are associated with quit attempts, and identify barriers to the effectiveness of spirometry in enhancing the quit attempt rate. These data will provide the framework for developing a future large clinical trial of the effectiveness of spirometry on smoking cessation. Cigarette smoking is the leading cause cancer-related death in the world. Therefore, quitting smoking is the most important behavioral intervention in cancer control. This project will determine whether measuring lung function in smokers and delivering the results to them using a strong motivational strategy will increase the likelihood that they will try to stop smoking. If so, then this strategy can be used in a large scale study to determine whether lung function results are effective in getting people to quit smoking.