A Mechanistic Test of Treatment Strategies to Foster Practice Quitting

促进戒烟的治疗策略的机械测试

• 批准号: 10700997
• 负责人: Amanda R Mathew
• 金额: $ 61.65万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700997
• 关键词: Abstinence; Accounting; Aftercare; Anxiety Disorders; Attitude; Behavioral; Cause of Death; Cessation of life; Chronic; Chronic Care; Chronic Disease; Cigarette; Cigarette Smoker; Cognition; Counseling; Distress; Event; Exercise; Expectancy; Fatigue; Fostering; Goals; Happiness; Head; Health; Health Personnel; Heterogeneity; Hour; Hypertension; Incidence; Individual; Instruction; Intention; Intervention; Intuition; Knowledge; Literature; Mediating; Mediator; Medical Care Costs; Morbidity - disease rate; Motivation; Nicotine; Nicotine Dependence; Nicotine Withdrawal; Outcome; Participant; Pathway interactions; Patients; Procedures; Process; Randomized; Readiness; Relapse; Research; Research Design; Resources; Role; Sampling; Self Direction; Self Efficacy; Severities; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Testing; Time; Tobacco; Tobacco Use Disorder; Tobacco use; United States; Withdrawal; Withdrawal Symptom; behavior change; design; disability; emotional symptom; expectation; health management; mortality; motivational enhancement therapy; nicotine exposure; nicotine replacement; novel; optimism; pharmacologic; physical symptom; population health; pressure; programs; recruit; secondary outcome; smoking cessation; therapy development; treatment effect; treatment program; treatment strategy; willingness

PROJECT SUMMARY/ ABSTRACT Tobacco use remains the single leading preventable cause of death and disability in the United States, accounting for 480,000 deaths and $170 billion in medical costs each year. Although most cigarette smokers eventually want to quit, the majority (80%) are not interested in quitting within the next month. Despite this, smoking cessation treatment programs are traditionally predicated on smokers’ motivations to quit, with treatments proceeding only among those willing to set a quit date. This stands in stark contrast to treatments for other chronic diseases (e.g., hypertension)—health care providers do not assess whether or not patients are ready to treat their high blood pressure, they simply identify the problem and initiate treatment. Tobacco treatment programs are beginning to move toward a similar strategy through population health management approaches; however, there is a dearth of treatment content applicable to smokers across a range of quit- readiness, particularly for those unwilling to set a quit date. One novel potential treatment strategy is to foster practice quitting (PQ), in which an individual attempts not to smoke for a few hours or days, without pressure or expectation to permanently quit. Although a growing body of evidence has supported the role of practice quitting in fostering permanent quit attempts and cessation, there is limited understanding of the mechanisms of PQ-focused treatment. Furthermore, no studies to date have attempted to disentangle treatment effects associated with behavioral vs. pharmacological intervention strategies to prompt practice quitting. The overall goal of the current research is to characterize treatment mediators of PQ-focused counseling and nicotine replacement therapy (NRT) sampling. We will use a 2x2 factorial study design to test the role of PQ counseling vs. Motivational Interviewing (MI) counseling, and NRT sampling (four-week supply of nicotine lozenges and patches) vs. none on incidence of quit attempts at 6-months post treatment. We hypothesize that PQ treatment components will have an additive effect, such that PQ counseling + NRT sampling will produce the highest incidence of quit attempts at 6 months post-treatment. Participants (N=780) will be recruited through a nationwide online recruitment strategy and all study procedures will be completed remotely. We will purposefully recruit smokers who are not planning to quit in the next 30 days, and will examine baseline quit motivation (i.e., motivation to quit in the next 6 months) as a potential moderator of treatment effect. Results will advance our understanding of the behavioral process of practice quitting and the mechanisms governing PQA-focused treatment strategies. This mechanistic evidence will address a key gap in the smoking cessation treatment development literature, with the potential to increase intervention reach and efficacy to reduce tobacco-related morbidity and mortality.

项目概要/摘要 烟草使用仍然是美国死亡和残疾的唯一可预防的主要原因， 每年造成 48 万人死亡和 1,700 亿美元的医疗费用。虽然大多数吸烟者 最终想要戒烟的人，大多数（80%）没有兴趣在下个月内戒烟。尽管如此， 戒烟治疗计划传统上以吸烟者的戒烟动机为基础， 治疗仅在那些愿意设定戒烟日期的人中进行。这与治疗形成鲜明对比 对于其他慢性疾病（例如高血压）——医疗保健提供者不会评估患者是否患有 当他们准备好治疗高血压时，他们只需找出问题并开始治疗即可。烟草 治疗方案开始通过人口健康管理转向类似的策略 方法；然而，缺乏适用于各种戒烟人群的治疗内容。 准备好，特别是对于那些不愿意设定戒烟日期的人。一种新颖的潜在治疗策略是促进 练习戒烟（PQ），即一个人在没有压力或没有压力的情况下尝试不吸烟几个小时或几天。 期望永久戒烟。尽管越来越多的证据支持实践的作用 戒烟在促进永久性戒烟尝试和戒烟方面，人们对其机制的了解有限 以 PQ 为重点的治疗。此外，迄今为止还没有研究试图理清治疗效果 与促进戒烟的行为与药物干预策略相关。整体 当前研究的目标是表征以 PQ 为中心的咨询和尼古丁的治疗介质 替代疗法（NRT）采样。我们将使用 2x2 析因研究设计来测试 PQ 咨询的作用 与动机访谈 (MI) 咨询和 NRT 采样（四周供应尼古丁含片和 治疗后 6 个月的戒烟尝试发生率。我们假设 PQ 治疗 成分将产生累加效应，例如 PQ 咨询 + NRT 采样将产生最高的效果 治疗后 6 个月尝试戒烟的发生率。参与者（N=780）将通过 全国线上招聘策略，所有学习程序将远程完成。我们将 有目的地招募未来30天内不打算戒烟的吸烟者，并检查戒烟基线 动机（即未来 6 个月内戒烟的动机）作为治疗效果的潜在调节因素。结果 将增进我们对戒烟行为过程和治理机制的理解 以 PQA 为重点的治疗策略。这一机制证据将解决戒烟方面的一个关键差距 治疗开发文献，有可能增加干预范围和疗效，以减少 与烟草有关的发病率和死亡率。