Smoking Cessation for Women at Risk of Cervical Cancer

描述(由申请人提供)： 吸烟已被发现与患宫颈肿瘤或鳞状细胞癌的风险增加两倍有关。烟雾的成分与人类乳头瘤病毒(HPV)相结合，可能会促进宫颈肿瘤的发生或发展。因此，HPV阳性和吸烟的女性患宫颈癌的风险更高。对于在阴道镜诊所接受筛查以评估巴氏涂片异常的妇女来说，关于戒烟的咨询可能特别有益。这被认为是戒烟的“启蒙时刻”，因为人们感觉到的患宫颈癌的风险增加了。戒烟可以降低这一风险以及其他健康风险。此外，阴道镜检查诊所的女性代表了服务不足的女性吸烟者，因为她们年轻，社会经济地位低，更有可能是少数民族或少数族裔。在第一阶段，将进行三个焦点小组，每个小组由8-10名妇女组成，以适应以小组为基础的有效的认知-行为戒烟干预，该干预是根据妇女的需要量身定做的。这些调整将包括将干预从小组干预修改为基于电话的交付形式，并解决我们研究地点阴道镜诊所女性独特的戒烟障碍。在第二阶段，改进后的材料将用于随机试点研究。30名妇女将被随机分为AHRQ+强化戒烟组(n=15)或AHRQ+接触对照组(n=15)。两组都将收到AHRQ戒烟指南(自助材料、简短咨询、尼古丁替代疗法建议)以及电话传递适应性戒烟干预(AHRQ+增强型戒烟)或健康教育干预(AHRQ+接触控制)。我们的主要假设是，与AHRQ+接触对照组相比，被随机分配到AHRQ+增强型戒毒组的女性戒烟率更高。因此，我们寻求：1)进行形成性工作，使戒烟材料从一个群体转变为基于电话的形式，并满足这一人群的需求；2)试行招募战略；3)进行小型随机试点试验，以确定戒烟材料的初步效果。因此，这项研究将作为更大规模临床试验的先导。

DESCRIPTION (provided by applicant): Cigarette smoking has been found to be associated with a two-fold increased risk of developing cervical neoplasia or squamous cell cancer. The constituents of smoke, in concert with human papillomavirus (HPV), may promote the development or progression of cervical neoplasia. Thus, women who are positive for HPV and who smoke are at increased risk for developing cervical cancer. Counseling regarding smoking cessation may be of particular benefit for women undergoing screening at a colposcopy clinic for the evaluation of an abnormal Papanicolaou (Pap) smear. This is considered to be a "teachable moment" for smoking cessation, in that the perceived risk of progression to cervical cancer is heightened. Smoking cessation can reduce this risk as well as other health risks. Additionally, women at the colposcopy clinic represent underserved female smokers in that they are young, of low socioeconomic status, and are more likely to be ethnic or racial minorities. In Phase I, three focus groups of 8 -10 women each will be conducted to adapt an efficacious group-based cognitive-behavioral smoking cessation intervention that is tailored to the needs of women. The adaptations will include modifying the intervention from a group to phone-based delivery format and addressing the unique smoking cessation barriers of the women at our study site colposcopy clinic. In Phase II, the refined materials will be used in a randomized pilot study. Thirty women will be randomized either to an AHRQ + Enhanced Smoking Cessation group (n = 15) or to an AHRQ + Contact Control group (n = 15). Both groups will receive the AHRQ guidelines for smoking cessation (self help materials, brief counseling, recommendation for nicotine replacement therapy) plus phone delivery of either the adapted smoking cessation intervention (AHRQ + Enhanced Cessation) or a health education intervention (AHRQ + Contact Control). Our primary hypothesis is that the women randomized to the AHRQ + Enhanced Cessation group will have higher quit rates then women in the AHRQ + Contact Control group. Thus, we seek to: 1) conduct the formative work to adapt the cessation materials from a group to phone-based format and to address the needs of this population, 2) pilot the recruitment strategy, and 3) conduct a small randomized pilot trial to determine the preliminary efficacy of the materials for smoking cessation. This study, therefore, will serve as a pilot for a larger clinical trial.