Internet and Telephone Treatment for Smoking Cessation

烟草使用是美国癌症和疾病负担的主要可预防原因，虽然存在有效的治疗方法，但需要有效的创新方法来加速减少吸烟流行率。电话咨询和量身定制的自我改变计划具有证据基础的功效和对人口流行率产生影响的能力。通过电话戒烟热线和通过互联网提供有针对性的自我改变，提供全面的烟草控制服务的运动越来越多。科学家、政策制定者和公众需要知道这些计划是否有效，对谁有效，通过什么机制有效，以及成本如何。目前还没有对互联网驱动的戒烟服务或结合电话和互联网治疗的有效性进行严格的评估。与此同时，基于互联网的计划已经向公众提供，并且正在大量使用，但没有任何证据表明它们是有效的。 本研究的目的是扩展现有的理论和应用，通过比较一个流行的，全方位的服务，互联网干预（高级互联网）单独或结合主动电话咨询（高级互联网加电话）对标准的互联网控制（基本互动）的功效。本研究将招募有动机的吸烟者（N= 2，055），他们使用互联网搜索引擎查找戒烟计划。一个子集将被定向到一个描述研究和入组程序的网页。采用3条件随机化设计，在基线、随机化后3、6、12和18个月重复测量，将知情同意的吸烟者分配至：1）基本互联网; 2）高级互联网; 3）高级互联网+主动电话咨询。检验的假设是，在随机化后12个月（治疗后6个月）测量的7天点患病率禁欲方面，高级互动加电话的表现优于单独的高级互联网，两者都优于基本互联网。还将沿着对关于结果的中介和调节因素的理论驱动假设的探索性分析来检查成本效益（例如，性别、服务使用的数量和频率、使用的内容类型和行为变化变量，包括自我效能、社会支持和动机）。 市场需求和州卫生部门正在刺激Interact和电话戒烟服务的提供。迫切需要科学来填补这一差距并评估其功效。如果有效，这种治疗方法可以广泛传播，并对人口健康产生重大影响。

DESCRIPTION (provided by applicant): Tobacco use is the major preventable cause of cancer and disease burden in the U.S. While effective treatments exist, innovative means of efficient delivery are needed to accelerate reduction in smoking prevalence. Telephone counseling and tailored self-change programs have an evidence-base of efficacy and the capability to make an impact on population prevalence. There is a growing movement to provide comprehensive tobacco control services, both through telephone quit lines and tailored self-change via the Internet. Scientists, policy makers and the public need to know if these programs work, for whom, by what mechanisms, and at what cost. There are no rigorous evaluations of the efficacy of Internet-driven cessation services or of combined telephone and Internet treatment At the same time, Internet-based programs are already available to the public and are being used at a very high volume without any evidence that they are effective. This study aims to extend existing theory and application by comparing the efficacy of a popular, full service, Internet intervention (Premium Internet) alone or in conjunction with proactive telephone counseling (Premium Internet plus Telephone) against a standard Internet control (Basic Interact). This study will recruit motivated smokers (N=2,055) who use an Internet search engine to find smoking cessation programs. A subset will be directed to a Web page that will describe the study and enrollment procedures. Using a 3-condition randomized design with repeated measures at baseline, 3, 6, 12, and 18-months post-randomization, consented smokers will be assigned to: 1) Basic Internet; 2) Premium Internet; and 3) Premium Internet plus Proactive Telephone Counseling. The hypotheses tested are that Premium Interact plus Telephone will outperform Premium Internet alone and both will outperform Basic Internet on 7-day point prevalence abstinence measured at 12 months post-randomization (6-months post treatment). Cost-effectiveness will also be examined along with exploratory analyses of theory-driven hypotheses about the mediators and moderators of outcome (e.g., gender, amount and frequency of service use, type of content used, and behavior change variables including self-efficacy, social support, and motivation). Market demand and State health departments are stimulating delivery of Interact and telephone cessation services. There is an urgent need for science to fill the gap and evaluate their efficacy. If effective, such treatments can be widely disseminated and can make a significant impact on population health.