Early Withdrawal Exposure and Negative Affect Withdrawal (NAW) Regulation Training for Smoking Cessation

在美国，吸烟仍然是最可预防的死亡和发病原因。 即使是最严格的戒烟疗法，长期戒烟率也在20%之间。 和35%。因此，研究继续调查新的戒烟干预措施是至关重要的。 当代关于成瘾动机的主要理论认为，逃避或避免负面影响 戒断(NAW)症状(例如，愤怒、焦虑和抑郁/悲伤)构成了强烈的动机 吸烟是吸烟的基础，在重新使用香烟方面起着关键作用。然而，鉴于NAW 症状似乎对戒烟治疗的结果有很大影响，戒烟 干预措施可能只会对NAW症状产生温和的影响。因此，有人提议 戒烟干预可以通过帮助吸烟者实施NAW法规来加强 战略。这项调查的主要目标是评估早期戒断暴露加净水 戒烟规章制度培训干预。具体目标包括评估 治疗成分，并调查治疗成分的潜在介体和调节剂。 参与者将是成年吸烟者(N=400)，每天至少抽5支香烟，并打算戒烟。 使用析因设计，参与者将被随机分配到早期戒断暴露(是与否)和 行为干预(NAW调节训练与放松控制训练)，导致四个不同的 条件。我们的主要假设是，早期戒断暴露加上NAW调节训练将产生 治疗结束后1、3和6个月的7天时点戒断率较高，提示 两个干预组成部分的协同(即，非相加)效应。调解人(例如，会议期间 戒断症状)和主持人(如人口统计特征、烟草依赖) 通过既定的分析进行了调查。这些数据将推进实验干预，重点放在 改变的目标机制以及干预可能针对的参与者特征 量身定做的。当前提案中描述的试验性干预有可能最终 加强现有戒烟干预措施的有效性，因此将独特地促进 菲尔德。

Cigarette smoking remains the single most preventable cause of mortality and morbidity in the United States. Long-term abstinence rates for even the most rigorous of smoking cessation treatments range between 20% and 35%. It is therefore essential that research continue to investigate novel smoking cessation interventions. Leading contemporary theories of addiction motivation posit that the escape or avoidance of negative affect withdrawal (NAW) symptoms (e.g., anger, anxiety, and depression/sadness) constitutes a strong motivational basis for cigarette smoking and plays a critical role in relapse to cigarette use. However, whereas NAW symptoms appear to exert a powerful influence on smoking cessation treatment outcome, smoking cessation interventions may exert only modest effects on NAW symptoms. Accordingly, it has been proposed that smoking cessation interventions may be augmented by aiding smokers in the practice of NAW regulation strategies. The primary goal of this investigation is to evaluate an early withdrawal exposure plus NAW regulation training intervention for smoking cessation. Specific aims include evaluating the efficacy of the treatment components and investigating potential mediators and moderators of the treatment components. Participants will be adult smokers (N = 400) of at least 5 cigarettes per day with the intention to quit smoking. Using a factorial design, participants will be randomized to early withdrawal exposure (yes vs. no) and behavioral intervention (NAW regulation training vs. relaxation control training), resulting in four distinct conditions. Our primary hypothesis is that early withdrawal exposure plus NAW regulation training will produce higher rates of seven-day point-prevalence abstinence at 1, 3, and 6 months after end-of-treatment, suggesting a synergistic (i.e., non-additive) effect of the two intervention components. Mediators (e.g., in-session withdrawal symptoms) and moderators (e.g., demographic characteristics, tobacco dependence) will be investigated via established analyses. These data will advance the experimental intervention with a focus on targeting mechanisms of change as well as participant characteristics to which the intervention may be tailored. The experimental intervention described in the current proposal has the potential to ultimately enhance the efficacy of existing smoking cessation interventions and will therefore contribute uniquely to the field.