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.

项目摘要/摘要 烟草使用仍然是美国的单一主要可预防死亡和残疾原因， 每年占480,000人死亡和1700亿美元的医疗费用。虽然大多数吸烟者 甚至想辞职，大多数（80％）对下个月的辞职都不感兴趣。尽管如此， 传统上，戒烟治疗计划是吸烟者退出动机的预测 仅在愿意设定戒烟日期的人中进行治疗。这与治疗形成鲜明对比 对于其他慢性疾病（例如，高血压） - 健康护理提供者未评估患者是否评估 准备治疗高血压，他们只是发现问题并引发治疗。烟草 治疗计划开始通过人群健康管理朝着类似的策略迈进 方法；但是，在一系列戒烟中，适用于吸烟者的治疗含量死亡 - 准备就绪，特别是对于那些不愿设定戒烟日期的人。一种新颖的潜在治疗策略是促进 练习安静（PQ），其中一个人试图在没有压力或 期望永久退出。尽管越来越多的证据支持实践的作用 退出永久性戒烟尝试和停止，对机制的理解有限 以PQ为中心的治疗。此外，迄今为止尚无研究试图解散治疗效果 与行为与药理干预策略有关，以促使练习安静。总体 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体 替代疗法（NRT）采样。我们将使用2x2阶乘研究设计来测试PQ咨询的作用 与动机访谈（MI）咨询和NRT采样（尼古丁lozenges和 贴片）与在治疗后6个月的戒烟事件中无用。我们假设PQ治疗 组件将产生额外的效果，因此PQ咨询 + NRT采样将产生最高 治疗后6个月的戒烟事件。参与者（n = 780）将通过 全国性的在线招聘策略和所有研究程序将远程完成。我们将 有目的地招募不打算在接下来30天内戒烟的吸烟者，并将检查基线退出 动机（即在接下来的6个月内退出的动机）作为治疗效应的潜在主持人。结果 将促进我们对实践安静的行为过程和管理机制的理解 以PQA为中心的治疗策略。这种机械证据将解决戒烟的关键差距 治疗开发文献，有可能提高干预措施和效率以减少 与烟草有关的发病率和死亡率。