NOVEL LAPSE-RESPONSIVE APPROACH TO SMOKING CESSATION

描述：（申请人摘要） 该治疗开发项目将提供有关 一种新的戒烟方法， 在前两个月内有过吸烟间歇的吸烟者 戒烟后的几周该模型是基于早期的观察结果， 吸烟中断是戒烟尝试失败的有力预测因素。 它利用了最有效的经验测试行为技术， 快速吸烟和咨询，结合安非他酮药物治疗，以测试 一种新的失误-偶然干预模式。快速吸烟与咨询是 预计可以抵消一些不利的认知和生理影响， 自发的早期吸烟通过反调节而失效。期间 3-一年的治疗开发项目，我们将1）编写一本手册，描述 新的失误-特遣队快速吸烟加咨询干预，2）培训和 适当的工作人员来管理治疗，3）实施治疗师 依从性和能力评估，4）进行开放性试点研究（n=12）， 新疗法，5）根据需要进行临时方案和手动更改，以及 6)在一项小样本（n=63）试点研究中评估新治疗方法， 失误者被随机分配到全面干预， 仅或控制条件下，没有特殊干预后， 第一次戒烟后的失误。我们的假设是，那些接受 快速吸烟的全面干预会有更好的结果 在所有随访时间点（1、3和6）， 停药后3个月）。这里的新颖概念是获得更可靠的 启动和早期戒烟后禁欲，没有长期成功 似乎不太可能，通过积极干预那些有早期 戒烟以改善预后。治疗程序 减少或扭转早期失效的不利影响可能是一个 在提高戒烟率方面取得重大突破。

DESCRIPTION: (Applicant's Abstract) This treatment development project will provide valuable information about a novel approach to smoking cessation that intervenes aggressively with poor prognosis smokers who have had a smoking lapse during the first two post-cessation weeks. The model is based on previous observations that early smoking lapse is a powerful predictor of failure in smoking cessation attempts. It utilizes the most potent available empirically tested behavioral techniques, rapid smoking and counseling, combined with bupropion pharmacotherapy, to test a new lapse-contingent model of intervention. Rapid smoking with counseling is expected to counteract some of the adverse cognitive and physiological effects of self-initiated early smoking lapses through counter-conditioning. During the 3-year treatment development project we will 1) write a manual describing the new lapse-contingent rapid smoking plus counseling intervention, 2) train an appropriate staff member to administer the therapy, 3) implement therapist adherence and competency assessments, 4) conduct an open pilot study (n=12) of the new therapy, 5) make interim protocol and manual alterations as needed, and 6) evaluate the new treatment in a small sample (n=63) pilot study in which lapsers are randomly assigned to the full intervention, to intensive counseling only or to a control condition with no special intervention following their first post-cessation smoking lapse. Our hypothesis is that those receiving the full intervention with rapid smoking will have significantly better outcomes than either of the control groups at all follow-up time points (1, 3 and 6 months post-cessation). The novel concept here is to obtain more reliable initiation and early post-cessation abstinence, without which long-term success appears unlikely, by proactively intervening with those who do have an early smoking lapse in an attempt to improve their prognosis. Therapeutic procedures that reduce or reverse the detrimental effects of early lapse could be a significant breakthrough in improving smoking cessation rates.