Internet Based Voucher Reinforcement for Smoking Cessation

描述（由申请人提供）：基于互联网的戒烟凭证强化：烟草使用仍然是美国发病率和死亡率的头号可预防原因。在任何其他人口中，吸烟的流行率和问题都比农村人口更为明显和突出，因为农村人口获得治疗的机会有限。目前的戒烟干预措施效果一般，这表明需要更密集、更创新和更容易获得的治疗方法。基于代金券的戒断强化疗法是一种高度密集的方法，其中患者获得货币代金券，可以根据记录的戒断交换商品和服务。为了提高想要戒烟的吸烟者获得这种强化治疗的可及性，一种新型的基于代金券的戒烟强化治疗已经被开发出来，其中吸烟状况经常通过互联网监测和加强。通过这种基于互联网的干预，收集吸烟者提供一氧化碳样本的实时视频并验证其吸烟状况。然后，根据已证实的吸烟状况，向患者提供反馈和强化。这种创新方法可能非常适合需要可获得的密集戒烟干预措施的农村吸烟者。这项拨款申请提出探索性研究，以适应、实施和评估一种新的基于互联网的代金券强化干预，用于肯塔基州农村重度吸烟者的戒烟。提出了一项试点研究，其中肯塔基州的农村吸烟者（N=80）将被随机分配到两组中的一组：偶然代金券组和非偶然代金券组。在6周的时间里，我们将使用基于互联网的一氧化碳监测系统每天两次收集和验证所有参与者的一氧化碳样本。分配到或有代金券组的参与者如果提供的CO样品<4ppm将获得货币代金券。非或有凭证组的参与者将收到独立于其CO样本的凭证。总体而言，本申请为开发和评估针对农村社区重度吸烟者的密集和可及的戒烟干预措施提供了研究建议，并为今后的研究提供了实证基础。

DESCRIPTION (provided by applicant): Internet-Based Voucher Reinforcement for Smoking Cessation: Tobacco use continues to be the number one preventable cause of morbidity and mortality in the United States. In no other population are the prevalence rates and problems of smoking more apparent and pronounced than those in rural populations, where access to treatment is limited. Current smoking cessation interventions are modestly effective, which suggest the need for therapies that are more intensive, innovative, and accessible. Voucher-based abstinence reinforcement therapy is a highly intensive approach wherein patients earn monetary vouchers that can be exchanged for goods and services contingent on documented abstinence. To improve the accessibility of this intensive therapy to smokers who want to quit smoking, a novel voucher based abstinence reinforcement therapy for smoking has been developed wherein smoking status is frequently monitored and reinforced via the internet. With this internet based intervention, real-time video of smokers providing CO samples are collected and verified for smoking status. Patients are then provided feedback and reinforcement based on their verified smoking status. This innovative approach may be well suited for rural smokers who are in need of accessible intensive smoking cessation interventions. This grant application proposes exploratory research to adapt, implement, and evaluate a novel internet based voucher reinforcement intervention for smoking cessation in heavy smokers in rural Kentucky. A pilot study is proposed in which rural smokers in Kentucky (N=80) will be randomly assigned to one of two groups: contingent vs. noncontingent vouchers group. For 6 weeks, CO samples will be collected and verified twice daily from all participants using an internet based CO monitoring system. Participants assigned to the contingent vouchers group will receive monetary vouchers if they provide a CO sample <4ppm. Participants in the noncontingent vouchers group will receive vouchers independent of their CO sample. Overall, the application proposes research to develop and evaluate an intensive and accessible smoking cessation intervention for heavy smokers in rural communites, and provide the empirical basis for future research.