Maintaining Nonsmoking: Treatment of Older Smokers

描述：(申请人提供) 这一系列研究的目标是开发和评估干预措施 保持无烟状态，并在此过程中更好地理解 为戒烟和复发干杯。这是一个与之竞争的延续应用程序 对于一个已经发表了42篇期刊文章，18本书章节的研究来说， 在20年的时间里有27篇摘要。 某些人口亚群面临持续吸烟和复发的风险； 吸烟者亚群是50岁以上的吸烟者，随着年龄的增加，吸烟者的数量正在增加 一般的人口年龄。吸烟是老年人的一个严重的健康风险因素 个人。戒烟显著降低死亡率和发病率 这个年龄段的癌症、心脏病和其他疾病。近期 实践指南呼吁研究吸烟者的药理策略 50多年了。数据表明，这些吸烟者高度依赖尼古丁， 有很高的“亚综合征抑郁症”的患病率。 我们小组与尼古丁依赖者和抑郁症吸烟者进行了广泛的合作。 这项早期的工作将被用来为创新的干预提供信息。因此， 拟议工作的具体目标是测试一系列关于 针对老年吸烟者的四种干预措施的效果和成本效益。 参与者(N=432)将随机分配到四种干预措施中的一种 条件：(1)咨询对照；(2)标准(12周)尼古丁替代 治疗(NRT)；(3)延长(52周)心理社会支持/标准NRT；(4) 延长心理社会支持/延长(52周)NRT。参与者将是 在基线上评估吸烟、尼古丁依赖、诊断、人口统计学、 情绪，社会支持，健康状况，改变的动力，药物和 酗酒。在第12、24、36、52和104周，将对参与者进行评估 经一氧化碳和阿那他滨/阿那巴辛核实的吸烟自我报告， 以及衡量情绪、社会支持、健康状况和改变动机的指标。 尿可替宁将在第104周采集。原型数据分析 战略就是天啊。此外，我们还将完成探索性分析，以确定 最佳预测吸烟治疗结果的变量及其差异 对老年吸烟者扩大干预的反应。

DESCRIPTION: (provided by applicant) The goal of this line of research is to develop and evaluate interventions that maintain nonsmoking, and in so doing, better understand the processes leading to smoking cessation and relapse. This is a competing continuation application for a line of research that has produced 42 journal articles, 18 book chapters, and 27 abstracts over a 20-year period. Certain population subgroups are at risk for continued smoking and relapse; one subgroup is smokers 50+ years of age, who are increasing in number as the general population ages. Smoking is a serious health risk factor for older individuals. Smoking cessation dramatically reduces mortality and morbidity from cancer, cardiac disease, and other illnesses in this age group. Recent practice guidelines call for research on pharmacological strategies for smokers 50+ years. Data indicates that these smokers are highly nicotine dependent and have a high prevalence of "subsyndromal depression." Our group has worked extensively with nicotine dependent and depressed smokers. This earlier work will be used to inform an innovative intervention. Thus, the specific aims of the proposed work are to test a series of hypotheses about the efficacy and cost-effectiveness of four interventions for older smokers. Participants (N=432) will be randomly assigned to one of four intervention conditions: (1) counseling control; (2) standard (12 week) Nicotine Replacement Therapy (NRT); (3) extended (52 week) psychosocial support/standard NRT; (4) extended psychosocial support/extended (52 week) NRT. Participants will be assessed at baseline on smoking, nicotine dependence, diagnosis, demographics, mood, social support, health status, motivation for change, and drug and alcohol use. At weeks 12, 24, 36, 52 and 104, participants will be assessed on self-reports of smoking verified by carbon monoxide and anatabine/anabasine, and measures of mood, social support, health status and motivation for change. Urinary cotinine will be collected at week 104. The prototypical data analysis strategy is GEE. Also, we will complete exploratory analyses to determine those variables that best predict smoking treatment outcome, and differential response to the extended interventions in older smokers.