Engineering Effective Interventions for Tobacco Use: A Translational Laboratory

描述（由申请人提供）：烟草使用对美国人的健康造成了巨大的损害，其流行率停滞在所有成年人的20%左右。以下几个因素阻碍了吸烟率的进一步下降：(1)开发更有效的戒烟干预措施进展缓慢；(2)循证干预措施使用率低；(3)干预措施的无效使用。拟议中心的主要目标是建立一个多学科实验室，旨在产生全面的（个人到系统级）戒烟干预。该NIDA卓越中心申请包括由四个核心支持的三个研究项目，这些项目将共同产生可翻译的、具有成本效益的和临床有效的戒烟干预包。总体方法方法以干预优化原则为指导。项目1将测试多个基于证据的干预成分，在戒烟尝试的不同阶段进行管理，以确定产生最佳戒烟成功的成分组合。项目2将测试两种不同类型的临床医生干预措施，这些干预措施由电子病历提示，旨在增加吸烟者使用基于证据的戒烟干预措施。项目3将测试三种不同类型的干预措施，旨在提高吸烟者对戒烟药物的有效使用。为了支持这些研究项目，中心将创建四个核心：管理、干预优化、方法、指导、教育和传播。这些机构将提供必要的行政、科学、教育和业务支持，以确保研究项目和中心整体的成功。总的来说，这个提议的卓越中心旨在展示创新的价值，多学科研究策略在生产最佳戒烟包；这些战略可适用于保健和药物滥用方面的各种问题。本卓越中心申请的总体目标是减少美国烟草使用的流行程度，以及由此产生的疾病、死亡和成本负担。

DESCRIPTION (provided by applicant): Tobacco use exacts an enormous toll on the health of America, with prevalence stalled at about 20% of all adults. Further reductions in smoking prevalence are impeded by several factors: (1) slow progress in the development of more effective cessation interventions; (2) low utilization of evidence-based interventions; and (3) ineffective use of interventions. The primary objective of the proposed Center is to establish a multidisciplinary laboratory designed to yield a comprehensive (individual to systems-level) smoking cessation intervention. This NIDA Center of Excellence application includes three research projects supported by four cores that together will produce a translatable, cost-effective, and clinically effective smoking cessation intervention package. The overall methodological approach is guided by the principles of intervention optimization. Project 1 will test multiple, evidence-based intervention components, administered at different phases of the cessation attempt, to identify the combination of components that produces optimal smoking cessation success. Project 2 will test two different types of clinician interventions that are prompted by the electronic medical record and designed to increase smokers' use of evidence-based cessation interventions. Project 3 will test three different types of interventions designed to increase smokers' effective use of cessation medication. In support of the research projects, the Center will create four cores: Administrative, Intervention Optimization, Methods, and Mentoring, Education, and Dissemination. These will provide the administrative, scientific, educational, and operational support needed to ensure the success of the research projects and the Center as a whole. Overall, this proposed Center of Excellence is designed to demonstrate the value of innovative, mutidisciplinary research strategies in producing optimal cessation packages; these strategies can be applied to diverse problems in health and drug abuse. The overarching goal of this Center of Excellence application is to reduce the prevalence of tobacco use in the United States, and the resulting burden of illness, death, and cost. PUBLIC HEALTH RELEVANCE: The health, economic, and human costs of tobacco use are profound. The proposed Center grant will bring together scientists from different fields to develop highly effective approaches to smoking cessation treatments and to ensure that they are used in clinics and healthcare settings. This integrated approach is expected to yield greatly improved population-wide reductions in smoking.