Smoking Cessation Intervention for Diabetic Patients

糖尿病患者的戒烟干预

• 批准号: 8327754
• 负责人: Susan E Ramsey
• 金额: $ 35.6万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8327754
• 关键词: Abstinence; Adaptive Behaviors; Address; Affect; Affective; Area; Behavior; Behavior Therapy; Behavioral; Clinical; Clinical Trials; Cognitive; Combination Medication; Combined Modality Therapy; Development; Diabetes Mellitus; Elements; Emotional; Feedback; Future; General Population; Health; Individual; Intervention; Knowledge; Life; Manuals; Measures; Mediating; Mental Depression; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Nicotine Withdrawal; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patients; Perception; Pharmacotherapy; Phase; Population; Prevalence; Protocols documentation; Randomized; Randomized Controlled Trials; Recommendation; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Risk; Sampling; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Specific qualifier value; Staging; Testing; Time; Training; Treatment Efficacy; Withholding Treatment; Work; base; coping; depressive symptoms; diabetic patient; distress tolerance; experience; improved; innovation; meetings; mortality; nicotine patch; nicotine replacement; novel; phase 1 study; phase 2 study; population health; programs; randomized trial; skills; smoking cessation; smoking relapse; successful intervention; therapy development; trial comparing

DESCRIPTION (provided by applicant): Individuals with Type 2 diabetes smoke at rates similar to those found in the general population, and the health consequences of smoking are particularly severe among smokers with diabetes. In fact, there appears to be a synergistic effect between smoking and diabetes on mortality. However, despite reports that highlight the importance of this work, a paucity of studies have been conducted to develop and test smoking cessation interventions tailored to meet the needs of individuals with diabetes. The small number of extant studies have yielded mixed results. Distress tolerance (DT) focused, acceptance-based interventions have demonstrated efficacy for smoking cessation, and there is increasing support for the conceptual model underlying these interventions among individuals with diabetes. The long-term objective of this research program is to improve smoking cessation treatment for individuals with Type 2 diabetes by developing and establishing the efficacy of a DT smoking cessation intervention tailored to this population. Furthermore, we seek to advance knowledge of the relationships among nicotine withdrawal, negative affect, distress tolerance, and smoking cessation outcomes among individuals with diabetes. In the present application, we propose to develop a DT intervention tailored to meet the needs of smokers with Type 2 diabetes. In the first phase of this project, we will develop and pilot the intervention with 18 patients. In the second phase of the project, we will conduct a preliminary, randomized trial with 54 patients to examine the efficacy of the DT intervention relative to a standard smoking cessation treatment (ST) that equates for therapist contact time. Patients in both conditions will receive the transdermal nicotine patch. We expect that, relative to the ST condition, patients randomized to the DT condition will have increased likelihood of smoking abstinence and increased latency to both smoking lapse and relapse. If the efficacy of this intervention can be established in this trial and in subsequent large scale randomized controlled trials, smokers with diabetes will have improved smoking cessation treatment options. The need for this work is great given the paucity of extant work in this area, the significantly heightened risk of morbidity and mortality from smoking among diabetic patients, the rapidly increasing rate of diabetes in the U.S., and an apparent stabilization of the smoking rate in recent years.

描述(申请人提供)：2型糖尿病患者的吸烟率与普通人群相似，吸烟对健康的影响在糖尿病吸烟者中尤为严重。事实上，吸烟和糖尿病在死亡率方面似乎存在协同效应。然而，尽管有报道强调了这项工作的重要性，但开发和测试戒烟干预措施以满足糖尿病患者需求的研究很少。现有的少量研究产生了好坏参半的结果。关注痛苦耐受(DT)的、基于接受的干预措施已经证明了戒烟的有效性，在糖尿病患者中，越来越多的人支持这些干预措施背后的概念模型。这项研究计划的长期目标是通过开发和建立针对这一人群量身定做的DT戒烟干预的有效性，来改善2型糖尿病患者的戒烟治疗。此外，我们试图促进对糖尿病患者尼古丁戒断、负面情绪、痛苦耐受性和戒烟结果之间关系的了解。在本申请中，我们建议开发一种专为2型糖尿病吸烟者量身定做的DT干预。在这个项目的第一阶段，我们将对18名患者进行干预开发和试点。在该项目的第二阶段，我们将对54名患者进行初步的随机试验，以检验DT干预相对于标准戒烟治疗(ST)的疗效，标准戒烟治疗(ST)与治疗师接触时间相等。这两种情况的患者都将接受尼古丁透皮贴片。我们预计，与ST状态相比，随机进入DT状态的患者将增加戒烟的可能性，并延长吸烟失败和复发的潜伏期。如果这种干预的效果可以在这项试验和随后的大规模随机对照试验中得到证实，那么患有糖尿病的吸烟者将有更好的戒烟治疗选择。考虑到这一领域现有工作的匮乏、糖尿病患者吸烟致病和死亡风险的显著增加、美国糖尿病发病率的迅速上升以及近年来吸烟率的明显稳定，这项工作的必要性非常大。