Technological Innovations in a Behavioral Treatment for Cigarette Smoking

吸烟行为治疗的技术创新

• 批准号: 7652157
• 负责人: JESSE DALLERY
• 金额: $ 38.26万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7652157
• 关键词: Abstinence; Address; Arts; Behavior Therapy; Behavioral; Carbon Monoxide; Clinic; Communities; Complement; Contracts; Control Groups; Counseling; Deposition; Developed Countries; Developing Countries; Economic Models; Information Technology; Internet; Intervention; Measurement; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Output; Participant; Patients; Pharmaceutical Preparations; Pharmacotherapy; Pilot Projects; Procedures; Psychological reinforcement; Qualifying; Randomized; Randomized Controlled Trials; Relapse; Risk Factors; Sampling; Self Administration; Smoker; Smoking; Smoking Status; Specific qualifier value; System; Technology; Testing; Treatment Effectiveness; Treatment Efficacy; Treatment outcome; United States; United States Public Health Service; Visit; abstracting; base; cigarette smoking; cost; critical period; efficacy testing; follow-up; innovation; mortality; programs; public health relevance; smoking cessation; social; technological innovation; user-friendly; voucher

DESCRIPTION (provided by applicant): Technological Innovations in a Behavioral Treatment for Cigarette Smoking Project Summary/Abstract Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. Although the United States Public Health Service endorses various pharmacotherapies and counseling for smoking cessation, the majority of patients relapse within six months, even when both treatments are used together. The limitations of current interventions highlight the urgent need for innovative, powerful, and community-friendly treatments. Abstinence reinforcement therapy is one such treatment. We developed and tested an internet-based monitoring system to verify and reinforce smoking abstinence by breath carbon monoxide (CO) output. By using this simple yet innovative method, we found that patients were highly engaged with the treatment, and that voucher reinforcement produced high rates of sustained abstinence in a group of heavy smokers (over 65% of the 400 CO samples were negative during treatment). In the proposed project, we will evaluate a broadly applicable, sustainable, and clinically feasible abstinence reinforcement intervention. The treatment delivery model integrates the reach and convenience of the internet with a state-of-the-art, empirically-derived behavioral treatment for cigarette smoking. Smokers will be randomly assigned to an abstinence reinforcement group or to a control group, and smoking status will be measured during treatment and at a 6-month follow-up. Treatment can continue uninterrupted during the initial weeks of a quit attempt, which growing evidence suggests is a critical period to promote long-term cessation. To complement our individualized user-friendly CO measurement technology and make the treatment even more personally salient to participants, we will incorporate a deposit contract procedure. Participants will contribute a specified amount of money that they can recoup based on evidence of abstinence. This method holds promise as a way to substantially offset the costs associated with treatment. Finally, we will employ a remote treatment delivery model such that distance will not be a barrier. The treatment can be disseminated to any qualified smoker in the United States. The proposed program is innovative and directly addresses some of the major limitations (cost, sustainability, access) inherent in traditional abstinence reinforcement delivery models, and it has the potential to be appealing and feasible for widespread dissemination. If the promise of the intervention is realized, it will reduce the high rates of morbidity and mortality associated with smoking. PUBLIC HEALTH RELEVANCE: Technological Innovations in a Behavioral Treatment for Cigarette Smoking Public Health Relevance Statement Cigarette smoking is the largest preventable risk factor for morbidity and mortality in the United States. The proposed treatment will integrate the reach and convenience of the internet with a state-of-the-art, empirically-derived behavioral treatment for cigarette smoking: abstinence reinforcement therapy. The current program is innovative and directly addresses some of the major limitations (cost, sustainability, dissemination) inherent in traditional abstinence reinforcement delivery models. The intervention has the potential to be appealing and feasible for widespread dissemination. As such, this technological innovation in a behavioral treatment for cigarette smoking holds significant promise as a way to reduce the high rates of morbidity and mortality associated with smoking.

描述（由申请人提供）：吸烟行为治疗的技术创新项目摘要/摘要吸烟是发达国家发病和死亡的最大可预防危险因素。尽管美国公共卫生服务认可各种药物疗法和戒烟咨询，但即使同时使用两种疗法，大多数患者也会在六个月内复发。当前干预措施的局限性凸显了对创新、有效和社区友好型治疗的迫切需要。禁欲强化疗法就是这样的一种治疗方法。我们开发并测试了一个基于互联网的监测系统，通过呼吸一氧化碳 (CO) 输出来验证和加强戒烟。通过使用这种简单而创新的方法，我们发现患者对治疗高度投入，并且凭证强化在一组重度吸烟者中产生了很高的持续戒烟率（治疗期间 400 个 CO 样本中超过 65% 呈阴性）。在拟议的项目中，我们将评估一种广泛适用、可持续且临床可行的禁欲强化干预措施。该治疗提供模式将互联网的覆盖范围和便利性与最先进的、基于经验的吸烟行为治疗结合起来。吸烟者将被随机分配到戒烟强化组或对照组，并在治疗期间和 6 个月的随访期间测量吸烟状况。在尝试戒烟的最初几周内，治疗可以不间断地继续，越来越多的证据表明，这是促进长期戒烟的关键时期。为了补充我们个性化的、用户友好的二氧化碳测量技术，并使治疗对参与者来说更加个人化，我们将纳入存款合同程序。参与者将贡献一定数额的资金，他们可以根据禁欲的证据收回这笔资金。这种方法有望成为大幅抵消治疗相关费用的一种方法。最后，我们将采用远程治疗提供模式，使距离不再成为障碍。该治疗方法可以传播给美国任何合格的吸烟者。拟议的计划具有创新性，直接解决了传统禁欲强化实施模式固有的一些主要限制（成本、可持续性、获取），并且具有广泛传播的吸引力和可行性。如果干预措施的承诺得以实现，它将降低与吸烟相关的高发病率和死亡率。 公共卫生相关性：吸烟行为治疗的技术创新 公共卫生相关性声明 吸烟是美国发病率和死亡率最大的可预防危险因素。拟议的治疗方法将把互联网的覆盖范围和便利性与最先进的、基于经验的吸烟行为治疗方法相结合：戒断强化疗法。当前的计划具有创新性，直接解决了传统禁欲强化实施模式固有的一些主要限制（成本、可持续性、传播）。该干预措施具有广泛传播的吸引力和可行性。因此，吸烟行为治疗的这项技术创新作为降低与吸烟相关的高发病率和死亡率的一种方法具有重大前景。