SELF HELP INTERVENTIONS IN UNDERSERVED OLDER SMOKERS

在美国，超过1300万50岁以上的吸烟者， 往往是沉重的，长期吸烟者谁更有可能有慢性 吸烟引起或加重的疾病。 老年吸烟者也是 在农村地区的比例过高。 戒烟可以降低发病率， 在整个生命周期中因致残性疾病和病症造成的死亡率。 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， 可观 最近强调自助，特别是 电话辅助的干预措施似乎特别适合老年城市居民， 和农村吸烟者，他们可能有物理和地理限制， 减少他们获得服务的机会。 拟议的研究将审查两种干预措施的有效性 相对于中年和老年人的控制条件，农村与城市 吸烟者。 受试者将是从11个县招募的1800名50岁以上的吸烟者 区域，并随机分配到三种干预措施之一：1）“信”-自助 手册+邮寄提示，以拨打反应性吸烟者热线（受试者拨打 2）“主动”-自助手册+主动 远程咨询电话（咨询师呼叫受试者）; 3）控制- 自助手册。 该手册针对50岁以上的吸烟者， 反应热线是提供给所有科目，虽然只有信件和 主动型受试者会收到呼叫提示。 受试者将在6、12和18个月时接受电话随访， 确定吸烟状况和其他吸烟/健康变量。 结果将包括这些的临床和成本效益 按性别、城乡地区和年龄分列的干预措施 分组。 此外，该项目将审查变革进程， 持续吸烟者与戒烟者的健康状况变化。

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.