Increasing Young Adult Smokers' Demand for Internet-Based Cessation Treatment

描述（由申请人提供）：吸烟仍然是美国过早发病和死亡的头号原因。国家数据显示，除18至24岁的年轻人外，所有年龄组的吸烟率都有所下降。这一年龄组的吸烟率估计为24%，这一比率自2003年以来一直保持稳定。国家数据表明，与老年人相比，年轻人戒烟的成功率较低，而且他们接受治疗的频率也较低。尽管相当大比例（72%）的年轻成年吸烟者有戒烟的动机，49%的人在过去一年中曾认真尝试戒烟，但在2005年试图戒烟的年轻成年吸烟者中，只有4%的人报告使用行为治疗。按年龄组报告戒烟治疗结果的随机试验显示，年轻人和其他成年吸烟者的结果相当。因此，年轻成年吸烟者的戒烟率可以随着循证戒烟治疗在这一人群中的扩大而提高。拟议研究的基本前提是，制定有效的策略，旨在增加年轻成年吸烟者对循证戒烟治疗的需求，将加速这一关键目标人群的戒烟率。本研究采用创新的研究方法实现以下具体目标：(1)实施多阶段市场测试策略，开发一系列理论驱动的基于互联网的信息，鼓励年轻成年吸烟者使用行为戒烟治疗；(2)实施随机对照疗效研究，以确定至少4个高效的沟通；(3)实施中断时间序列（ITS）研究，评估现实条件下沟通的有效性和成本效益，以提高年轻成年吸烟者参与循证行为干预。ITS将精确检测信息在一段时间内刺激年轻成年吸烟者戒烟治疗需求的有效性趋势的程度和持续时间；(4)对年轻成人治疗参与者样本进行纵向队列研究，以便：(a)描述治疗的模式和参与程度，(b)模拟与治疗使用、戒烟尝试和成功戒烟相关的因素。公共卫生相关性：中期数据表明，在吸烟率方面实现2010年健康人目标的可能性很小。因此，烟草使用很可能仍然是下一代年轻成年吸烟者过早死亡和残疾的头号原因。尽管有有效的戒烟治疗，但对这些治疗的需求仍然低得令人失望，尤其是在年轻人中。关于提高对循证治疗需求的策略的研究很少。拟议的研究将有助于弥合有效戒烟治疗的可用性和使用之间的差距。

DESCRIPTION (provided by applicant): Cigarette smoking remains the number one cause of premature morbidity and mortality in the United States. National data show reductions in smoking prevalence among all age groups except for 18 to 24 year old young adults. Smoking prevalence in this age group is estimated at 24%, and this rate has held steady since 2003. National data indicate that compared to older adults, young adults are less successful at quitting, and they use treatment less often. Even though a sizeable proportion (72%) of young adult smokers are motivated to quit, and 49% have made a serious attempt to quit in the past year, only 4% of young adult smokers who attempted to quit in 2005 reported using behavioral treatment. Randomized trials of cessation treatments that report outcomes by age group show comparable outcomes for young adult and other adult smokers. Thus, quit rates among young adult smokers could improve with increased reach of evidence-based cessation treatments into this population. The underlying premise of the proposed study is that the development of effective strategies aimed to increase demand for evidence-based smoking cessation treatments among young adult smokers will accelerate rates of cessation in this key target population. The proposed study applies innovative research methods to achieve the following specific aims: (1) Implement a multi-phase market test strategy to develop a series of theory-driven internet- based messages to encourage use of behavioral cessation treatments among young adult smokers; (2) Implement a randomized controlled efficacy study to identify a minimum of 4 highly efficacious communications; (3) Implement an interrupted time series (ITS) study to assess the effectiveness and cost effectiveness of the communications under real-world conditions to increase young adult smokers' participation in evidence-based behavioral interventions. The ITS will provide precise detection of the magnitude and duration of trends in the effectiveness of the messages over time in stimulating demand for cessation treatment among young adult smokers; and (4) Conduct a longitudinal cohort study with a sample of young adult treatment participants in order to: (a) Describe patterns and degree of engagement with treatment, and (b) Model factors associated with use of treatment, smoking cessation attempts, and successful smoking cessation. PUBLIC HEALTH RELEVANCE: Interim data indicate little chance of reaching Healthy People 2010 goals with regard to smoking prevalence. Thus, tobacco use is likely to remain the number one cause of premature death and disability into the next generation of young adult smokers. Despite the availability of effective smoking cessation treatments, demand for these treatments remains disappointingly low, particularly among young adults. Little research exists on strategies to enhance demand for evidence-based treatment. The proposed research will help to bridge this gap between the availability and use of effective smoking cessation treatments.