A NOVEL HARM REDUCTION APPROACH FOR RESISTANT SMOKERS

吸烟风险与剂量密切相关。随着每日香烟消费量的增加，肺癌的风险从10倍跃升至70倍。减少烟草接触及其相应的危害是向不愿或不能戒烟的抵抗性吸烟者过渡的第一步。传统上，戒烟计划的目标是高度积极的吸烟者准备戒烟或采取行动。然而，80%的烟草使用者不打算在未来6个月内尝试戒烟。50%的人永远不会放弃。原因包括不愿意放弃快乐，对过去的失败感到沮丧，以及对副作用的容忍。偶尔，“盔甲上的裂缝”出现了，吸烟者开始认真地减少吸烟。人们日益认识到，减少吸烟是将顽固的烟草使用者推向减少危害和改变的后期阶段的第一步，包括戒烟的理想。减少吸烟可能会深入到那些预先考虑和不妥协的人群中，否则他们就会反应迟钝。成功实现更有限的目标可能会重建自我效能丧失。这项研究将展示一项技术突破，提供一种计划减少方案，将使用量减少到并保持在基线的50%。复杂的生物标志物将证实致癌物质、毒素和尼古丁的摄入减少。拟议的商业应用：目前还没有针对4800万不愿或不能戒烟的80%吸烟者的基础广泛的方案或商业交付工具。这种非处方的计划戒烟治疗装置被用作：(1)对最顽固的吸烟者进行高效的自助行为治疗，(2)辅助其他医疗护理，(3)精确监测和定制治疗的研究工具。

Smoking risks are strongly dose-related. Lung cancer risks are shown to leap from 10-fold to 70-fold with increased daily cigarette consumption. To reduce tobacco exposure and its corresponding hazards is a first step in transitioning resistant smokers who are unwilling or unable to commit to quitting. Traditionally, abstinence programs target the highly- motivated smoker ready to quit or take action. 80% of tobacco users, however, do not plan an attempt in the next six months. 50% will never quit. Reasons cited include unwillingness to forego the pleasure, discouragement with past failures, and intolerance of side effects. Occasionally, a "chink in the armor" appears and smokers become open to seriously cutting back. Smoking reduction is increasingly recognized as a first step in moving refractory tobacco users toward harm reduction and later stages of change, including the ideal of abstinence. Smoking reduction may reach deeper into pre-contemplative and intransigent segments who are otherwise unresponsive. Success at achieving more limited goals may rebuild self-efficacy loss. This study will demonstrate a technological breakthrough that delivers a scheduled reduction regimen programmed to decrease to and maintain usage at 50% of baseline. Sophisticated biomarkers will verity reduction in uptake of carcinogens, toxins and nicotine. PROPOSED COMMERCIAL APPLICATIONS: No broad-based protocol or commercial delivery instrument presently exists for the 80% of the 48-million smokers who are unwilling or unable to quit. This over-the-counter therapy device for scheduled reduction is used as: (1) a highly-effective self-help behavioral treatment for the most refractory smokers, (2) an adjunct to other medical care, and (3)a research tool to precisely monitor and tailor treatments.