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.

项目总结/摘要 在美国，烟草使用仍然是导致死亡和残疾的唯一主要可预防原因， 每年有48万人死亡，医疗费用高达1700亿美元。虽然大多数吸烟者 最终想要戒烟，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是基于吸烟者戒烟的动机， 治疗只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）-卫生保健提供者不评估患者是否 准备好治疗他们的高血压，他们只是发现问题并开始治疗。烟草 通过人口健康管理，治疗计划开始向类似的战略发展 方法;然而，缺乏适用于戒烟范围内的吸烟者的治疗内容， 准备，特别是对于那些不愿意设定退出日期的人。一种新的潜在治疗策略是培养 实践戒烟（PQ），其中一个人尝试不吸烟几个小时或几天，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 戒烟在促进永久戒烟尝试和戒烟方面，人们对机制的了解有限 以PQ为中心的治疗。此外，迄今为止还没有研究试图解开治疗效果 与行为与药物干预策略相关，以促进实践戒烟。整体 目前研究的目的是描述以PQ为中心的咨询和尼古丁的治疗介质 替代治疗（NRT）采样。我们将使用2x2析因研究设计来测试PQ咨询的作用 vs.动机访谈（MI）咨询和NRT采样（为期四周的尼古丁含片供应， 贴剂）与无贴剂对治疗后6个月戒烟尝试的发生率的影响。我们假设PQ治疗 成分将具有累加效应，例如PQ咨询+ NRT抽样将产生最高的 治疗后6个月的戒烟尝试发生率。参与者（N=780）将通过 全国在线招募策略，所有研究程序将远程完成。我们将 有目的地招募在未来30天内不打算戒烟的吸烟者，并将检查基线戒烟 动机（即，在接下来的6个月内戒烟的动机）作为治疗效果的潜在调节剂。结果 有助于我们进一步理解实践退出的行为过程和控制机制 以PQA为重点的治疗策略。这一机制性证据将解决戒烟中的一个关键空白 治疗开发文献，有可能增加干预范围和疗效， 与烟草有关的发病率和死亡率。