A Novel Treatment to Boost Quit Attempts and Cessation Among Unmotivated Smokers

描述（由申请人提供）：增加戒烟不仅可以通过增加戒烟尝试的成功率，还可以通过增加戒烟尝试的概率来实现。虽然政策干预增加了戒烟尝试，但临床医生为激励个体吸烟者戒烟而采取的少数治疗方法要么效果很小，要么效果不一致。考虑到在过去的十年中，吸烟者中戒烟尝试的发生率并没有增加，这一点尤其成问题。一种被广泛使用的促使人们认真尝试戒烟的方法是鼓励实践戒烟的尝试，就像伟大的美国吸烟（GAS）和世界无烟日（WNSD）所做的那样。我们假设提供尼古丁替代疗法（NRT）用于练习戒烟尝试将使尝试更成功，减少不舒服，从而增加以后有目的的永久戒烟尝试的可能性。我们之前的一项研究和其他研究表明，在没有戒烟动机的吸烟者中，提供NRT来减少每天的吸烟量会增加他们未来的戒烟尝试，但没有人测试过使用NRT来帮助戒烟尝试是否也会这样做。我们相信提供NRT会减少戒断期间的痛苦，产生更有利的使用NRT的态度，并增加戒烟的自我效能。有趣的是，其他人的假设正好相反；也就是说，为终身戒断以外的目标提供NRT将减少而不是增加未来的戒烟尝试。我们建议进行一项随机临床试验，a)简短建议进行a = 24小时练习戒烟尝试或b)简短建议加免费NRT。试验方法将与我们之前的研究非常相似。将通过随机拨号和行为测试招募744名无动机吸烟者作为样本，其中只包括那些目前没有戒烟计划的人。所有的治疗和评估将通过电话和邮件进行。虽然我们的研究将评估一些戒烟尝试的定义，但我们的主要结果是在六个月的研究期间内认真尝试永久戒烟的发生率。我们还将评估点普遍禁欲作为次要结果，并将测试我们假设的任何NRT效应的介质。如果成功，这项研究将1)为临床医生提供一种新的治疗选择，以激励吸烟者尝试戒烟；2)测试使用NRT治疗非戒烟结果是否会破坏戒烟的假设是正确的；3)建议重新标记非处方NRT的测试，包括非戒烟目的的使用，如实践戒烟尝试和向个人提供NRT样本的测试。

DESCRIPTION (provided by applicant): Increasing smoking cessation can be accomplished not only by increasing the success of a given quit attempt but also by increasing the probability of making a quit attempt. Although policy interventions increase quit attempts, the few treatments for clinicians to motivate individual smokers to make a quit attempt have either small or inconsistent effects. This is especially problematic given the incidence of quit attempts among smokers over the past decade is not increasing. One widely used method to prompt serious quit attempts is to encourage practice-quit attempts as is done by the Great American Smoke out (GAS) and World No Smoking Day (WNSD). We hypothesize providing nicotine replacement therapy (NRT) to use in a practice-quit attempt will make the attempt more successful and less uncomfortable and thus increase the probability of later purposeful attempts to quit smoking permanently. A prior study of ours and other studies have shown that providing NRT to reduce cigarettes per day in smokers not motivated to quit increases their future quit attempts, but no one has tested whether using NRT to aid practice quit attempts also does so. We believe providing NRT will reduce distress during abstinence, produce more favorable attitudes to using NRT and increase self-efficacy for quitting. Interestingly, others have hypothesized the opposite; i.e. that the provision of NRT for goals other than life-long abstinence will decrease rather than increase future quit attempts. We propose a randomized clinical trial of a) brief advice to undertake a = 24 hr practice quit attempt or b) brief advice plus free NRT. Trial methods will be very similar to our prior study. A population-based sample of 744 unmotivated smokers will be recruited via random-digit dialing and a behavioral test to include only those with no current plans to quit. All treatments and assessments will be delivered via telephone and mailings. Though our study will assess a number of quit attempt definitions, our primary outcome is the incidence of a serious attempt to permanently stop smoking made over a six-month study period. We will also assess point prevalent abstinence as a secondary outcome and will test our hypothesized mediators of any NRT effects. If successful, this study will 1) offer a new treatment option for clinicians to motivate smokers to try to quit, 2) test whether the hypothesis that using NRT for non-abstinence outcomes undermines abstinence is correct, and 3) suggest tests of relabeling over-the-counter NRT to include use for non-cessation purposes such as practice quit attempts and tests of providing NRT samples to individuals.