PRIMARY CARE AND SELF HELP INTERVENTION FOR TEEN SMOKERS

描述：（申请人描述）超过300万青少年吸烟 香烟，每天3,000支。 大多数人会继续吸烟， 据估计，1995年将有500万0-17岁的人最终死于 吸烟相关疾病 虽然研究工作集中在方法上， 为了防止青少年吸烟，关于如何 帮助三分之一的青少年吸烟。 有效停止 干预措施是减少这一人群吸烟率的关键。 临床医生和自助干预特别适合于 这一群体，因为他们允许针对大的和地理上的 不同的人群，同时保持机密联系， 对这个年龄段的人来说很重要 拟定的研究将 检查基于卫生保健提供者的干预措施的有效性， 为14-18岁的青少年吸烟者提供自助戒烟服务。 90名儿科和 青少年的做法将招募在6个县的地区，20 青少年/实践共1800例受试者。 实践将是 在关键变量上封闭并随机分配：1）干预-医生， 吸烟干预的执业护士和医师助理培训 （遵循NCI和AHCPR指南）和自助咨询师（自助咨询师） 手册、热线电话、主动电话、互联网资源）或2）家庭护理。 干预措施和实践层面的实施将以重点为指导 第一年的反馈。 受试者将在3点和4点通过电话随访， 12个月用于确定吸烟状况，使用自助资源， 以及其他吸烟/健康变量。 卫生保健提供者将接受调查 培训前后以及自我报告的12个月随访 青少年吸烟筛查和干预;青少年受试者 还将询问是否接受这些服务。 本研究将 为有效的戒烟干预提供证据， 青少年，并将协助规划未来的干预工作， 这个人口。

DESCRIPTION: (Applicant's Description) Over 3 million adolescents smoke cigarettes, with 3,000 starting each day. Most will continue to smoke, and an estimated 5 million people ages 0-17 in 1995 will ultimately die from a smoking-related disease. Although research efforts have focused on methods for preventing adolescent smoking, there are little data available on how to help the one-third of adolescents who smoke. Effective cessation interventions are key to reducing smoking prevalence in this population. Both clinician- and self-help interventions are particularly appropriate to this population, as they allow for targeting large and geographically diverse populations, while maintaining confidential contact that is developmentally important to this age group. The proposed study will examine the effectiveness of a health care provider-based intervention with self help adjuncts for adolescent smokers ages 14-18. Ninety pediatric and adolescent practices will be recruited in a 6 county area, with 20 adolescents/practice for a total of 1800 subjects. Practices will be blocked on key variables and randomized to: 1) Intervention - physician, nurse practitioner, and physician assistant training in smoking intervention (following NCI and AHCPR guidelines), and self-help adjuncts (self-help manual, hotline, proactive calls, Internet resources) or 2) Usual care. Interventions and practice level implementation will be guided by focus group feedback in year 1. Subjects will be followed by telephone at 3 and 12 months for determination of smoking status, use of self-help resources, and other smoking/health variables. Health care providers will be surveyed pre- and post training and at 12 month follow-up to regarding self-reported smoking screening and intervention with adolescents; adolescent subjects will also be queried regarding receipt of these services. This study will provide evidence for effective smoking cessation interventions for adolescents, and will assist in planning future intervention efforts with this population.