Positive Psychotherapy for Smoking Cessation Enhanced with Text Messaging: A Randomized Controlled Trial

项目摘要/摘要 仍然迫切需要提高行为咨询的有效性，以促进 长期戒烟。在过去的两年里，积极心理学的研究发展迅速。 几十年，并为开发新的和更有效的方法提供了一个宝贵的视角 可能具有广泛吸引力的成瘾治疗。建立在大量研究的基础上 积极心理干预增加积极情绪，减少压力和抑郁，我们最近 开发并试点了一种名为积极戒烟心理疗法的疗法(PPT-S)。PPT-S 旨在利用个人力量帮助戒烟，加强对精神健康的关注 戒烟的好处，并增加对积极经历和 戒烟时的认知问题。在一项试点随机对照试验中，PPT-S导致吸烟几率增加 与时间匹配的对照条件相比，戒酒超过6个月的随访情况。我们还发现， 更多地参与PPT一致的策略与随着时间的推移戒酒的几率增加有关， 那些具有更高基线积极情绪的人采用了更一致的PPT策略，并且有效性 PPT-S在较高的积极情感水平上表现最好。结果显示了PPT-S和 建议增加对PPT一致的行为和认知策略的参与，特别是对那些 具有较低的正性情感，可能会进一步提高这一方法的疗效。为此，我们有 开发了PPT-S(PPT-S+)的增强版本，使用短信提供PPT相关内容 并促进日常参与PPT一致的战略；试点测试表明这一点具有很高的可接受性 参与者回复超过80%的日常互动短信的方法。总的目标是 建议的项目是进行随机对照试验，以测试PPT-S+的疗效。具体来说，我们 将340名吸烟者随机分为PPT-S+戒烟组或时间匹配的标准行为戒烟组 治疗加短信(ST+)。这两种治疗条件都将包括尼古丁替代疗法和 对戒烟的短信干预。我们将检验PPT-S+将导致的假设 与ST+相比，吸烟效果更好，这种影响将通过更多地参与到 PPT-一致的策略，提高戒烟的自我效能，并减少对 抽烟。我们还将研究PPT-S+对那些基线较高的人的影响是否仍然更强 即使利用短信来增加治疗参与度，也会产生积极的影响。这个项目可以有 通过建立高度创新的改进方法的有效性来显著影响公共卫生 行为戒烟咨询，可以很容易地实施，并可能吸引广泛的 由于它强调个人优势并提高整体福祉和幸福感，因此吸引了一系列吸烟者。

Project Summary/Abstract There continues to be an urgent need to increase the effectiveness of behavioral counseling for promoting long-term smoking cessation. Research on positive psychology has been growing rapidly over the past two decades and provides a valuable perspective for developing novel and more effective approaches to addictions treatment that are likely to have broad appeal. Building from a substantial body of research on positive psychology interventions for increasing positive affect and reducing stress and depression, we recently developed and pilot tested a treatment called Positive Psychotherapy for Smoking Cessation (PPT-S). PPT-S is designed to harness personal strengths to assist smoking cessation, to enhance focus on the mental health benefits of quitting smoking, and to increase the frequency of and the attention to positive experiences and cognitions during quitting. In a pilot randomized controlled trial, PPT-S resulted in greater odds of smoking abstinence over 6 months of follow-up compared to a time-matched control condition. We also found that greater engagement in PPT-consistent strategies was associated with increased odds of abstinence over time, that those with higher baseline positive affect engaged in more PPT-consistent strategies, and that the efficacy of PPT-S was greatest at higher levels of positive affect. Results show the potential promise of PPT-S and suggest that increasing engagement in PPT-consistent behavioral and cognitive strategies, especially for those with low positive affect, may further enhance the efficacy of this approach. Towards this end, we have developed an enhanced version of PPT-S (PPT-S+) that uses text messaging to provide PPT-related content and to prompt daily engagement in PPT-consistent strategies; pilot testing indicates high acceptability of this approach with participants responding to over 80% of daily interactive text messages. The overall objective of the proposed project is to conduct a randomized controlled trial to test the efficacy of PPT-S+. Specifically, we will randomize 340 smokers to either PPT-S+ or a time-matched standard behavioral smoking cessation treatment plus text messaging (ST+). Both treatment conditions will include nicotine replacement therapy and a text-messaging intervention for smoking cessation. We will test the hypotheses that PPT-S+ will result in superior smoking outcomes compared to ST+ and that this effect will be mediated by greater engagement in PPT-consistent strategies, increased self-efficacy for quitting smoking, and reduced residual attraction to smoking. We also will examine whether the effect of PPT-S+ remains stronger for those with higher baseline positive affect even when text messaging is utilized to increase treatment engagement. This project can have significant public health impact by establishing the efficacy of a highly innovative approach to improving behavioral smoking cessation counseling, which can be readily implemented and is likely to appeal to a broad range of smokers due to its emphasis on personal strengths and enhancing overall well-being and happiness.