SELF HELP INTERVENTIONS IN UNDERSERVED OLDER SMOKERS

描述：在美国，超过1300万的50岁以上的吸烟者，以及 往往是重度、长期吸烟者，他们更有可能患有慢性 吸烟引起或加重的疾病。年龄较大的吸烟者也是 在农村地区的比例过高。戒烟可以降低发病率和 一生中因致残性疾病和疾病而死亡。 因此，吸烟和戒烟对维持 老年人和农村人口的健康和独立生活是 相当可观。最近对自助的强调，特别是 在电话辅助下，干预措施似乎特别适合老城区 以及农村吸烟者，他们可能有身体和地理上的限制， 减少他们获得服务的机会。 拟议的研究将检验两种干预措施的有效性。 相对于中年和老年农村与城市的控制条件 吸烟者。研究对象是从11个县招募的1800名50岁以上的吸烟者 并随机分为三种干预措施之一：1)“信件”--自助 手册+邮件提示拨打被动吸烟者热线(受试者电话 拨打热线)；2)“主动”--自助手册+主动 远程电话(辅导员呼叫受试者)；3)控制- 一本自助手册。该手册针对的是50岁以上的吸烟者， 所有受试者都可以使用反应热线，尽管只有信件和 积极主动的受试者会收到打电话的提示。 受试者将在6个月、12个月和18个月时通过电话进行 确定吸烟状况和其他吸烟/健康变量。 结果将包括这些方案的临床和成本效益 按性别、跨城乡和跨年龄分列的干预措施 分组。此外，该项目将审查变化的过程，以及 持续吸烟者与戒烟者健康状况的变化。

DESCRIPTION: Over 13 million are smokers aged 50+ in the United States, and tend to be heavy, long-term smokers who are more likely to have chronic diseases cause or exacerbated by smoking. Older smokers also are overrepresented in rural areas. Stopping smoking can reduce morbidity and mortality from disabling diseases and conditions across the life span. Thus, the implications of smoking and smoking cessation for maintenance of health and independent living for older and rural populations are considerable. Recent emphasis on self-help, and particularly telephone-assisted, interventions seem especially appropriate to older urban and rural smokers who may have both physical and geographic limitations that reduce their access to services. The proposed study will examine the effectiveness of two such interventions relative to a control condition for mid-life and older rural vs. urban smokers. Subjects will be 1800 smokers aged 50+ recruited from an 11 county area and randomized to one of three interventions: 1) "Letters" - self-help manuals + mailed prompts to call a reactive smokers' hot line (subjects call in to the hot line); 2) "Proactive" - self-help manual + proactive telecounseling calls (counselors call out to subjects); 3) Control - self-help manual alone. The manual is targeted to smokers aged 50+, and the reactive hot line is available to all subjects, although only Letters and Proactive subjects will receive cues to call. Subjects will be followed by telephone at 6, 12, and 18 months for determination of smoking status and other smoking/health variables. Outcomes will include the clinical and cost effectiveness of these interventions by gender, across rural and urban areas, and across age groupings. In addition, the project will examine processes of change, and changes in health status for continuing smokers vs. quitters.