Technological Innovations in a Behavioral Treatment for Cigarette Smoking

描述（由申请人提供）：吸烟行为治疗的技术创新项目摘要/摘要吸烟是发达国家发病率和死亡率的最大可预防风险因素。虽然美国公共卫生署认可各种药物治疗和戒烟咨询，但大多数患者在六个月内复发，即使两种治疗同时使用。目前干预措施的局限性突出了对创新，强大和社区友好的治疗的迫切需要。禁欲强化疗法就是这样一种治疗方法。我们开发并测试了一个基于互联网的监测系统，通过呼吸一氧化碳（CO）输出来验证和加强戒烟。通过使用这种简单而创新的方法，我们发现患者高度参与治疗，并且在一组重度吸烟者中，代金券强化产生了高比例的持续戒烟（400个CO样本中超过65%在治疗期间呈阴性）。在拟议的项目中，我们将评估一个广泛适用的，可持续的，临床可行的禁欲强化干预。治疗提供模式将互联网的覆盖范围和便利性与最先进的、衍生于吸烟的行为治疗相结合。吸烟者将被随机分配到戒烟强化组或对照组，并在治疗期间和6个月随访时测量吸烟状况。在戒烟尝试的最初几周，治疗可以不间断地继续下去，越来越多的证据表明，这是促进长期戒烟的关键时期。为了补充我们个性化的用户友好型CO测量技术，并使治疗对参与者更加个性化，我们将纳入存款合同程序。参与者将贡献一个指定的金额，他们可以收回的基础上禁欲的证据。这种方法有希望作为一种大大抵消与治疗相关的费用的方法。最后，我们将采用远程治疗交付模式，这样距离就不会成为障碍。这种治疗方法可以传播给美国任何合格的吸烟者。拟议的计划是创新的，直接解决了传统禁欲强化交付模式固有的一些主要限制（成本，可持续性，获取），它有可能吸引人，并广泛传播。如果干预措施的承诺得以实现，它将降低与吸烟有关的高发病率和死亡率。 公共卫生相关性：吸烟行为治疗的技术创新公共卫生相关性声明吸烟是美国发病率和死亡率的最大可预防风险因素。拟议的治疗将整合互联网的覆盖范围和便利性，以及最先进的、衍生于吸烟的行为治疗：戒烟强化疗法。目前的计划是创新的，直接解决了传统禁欲强化交付模式中固有的一些主要限制（成本，可持续性，传播）。这种干预措施有可能具有吸引力，并可广泛传播。因此，这种针对吸烟行为治疗的技术创新，作为降低与吸烟相关的高发病率和死亡率的一种方式，具有重大的前景。

DESCRIPTION (provided by applicant): Technological Innovations in a Behavioral Treatment for Cigarette Smoking Project Summary/Abstract Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. Although the United States Public Health Service endorses various pharmacotherapies and counseling for smoking cessation, the majority of patients relapse within six months, even when both treatments are used together. The limitations of current interventions highlight the urgent need for innovative, powerful, and community-friendly treatments. Abstinence reinforcement therapy is one such treatment. We developed and tested an internet-based monitoring system to verify and reinforce smoking abstinence by breath carbon monoxide (CO) output. By using this simple yet innovative method, we found that patients were highly engaged with the treatment, and that voucher reinforcement produced high rates of sustained abstinence in a group of heavy smokers (over 65% of the 400 CO samples were negative during treatment). In the proposed project, we will evaluate a broadly applicable, sustainable, and clinically feasible abstinence reinforcement intervention. The treatment delivery model integrates the reach and convenience of the internet with a state-of-the-art, empirically-derived behavioral treatment for cigarette smoking. Smokers will be randomly assigned to an abstinence reinforcement group or to a control group, and smoking status will be measured during treatment and at a 6-month follow-up. Treatment can continue uninterrupted during the initial weeks of a quit attempt, which growing evidence suggests is a critical period to promote long-term cessation. To complement our individualized user-friendly CO measurement technology and make the treatment even more personally salient to participants, we will incorporate a deposit contract procedure. Participants will contribute a specified amount of money that they can recoup based on evidence of abstinence. This method holds promise as a way to substantially offset the costs associated with treatment. Finally, we will employ a remote treatment delivery model such that distance will not be a barrier. The treatment can be disseminated to any qualified smoker in the United States. The proposed program is innovative and directly addresses some of the major limitations (cost, sustainability, access) inherent in traditional abstinence reinforcement delivery models, and it has the potential to be appealing and feasible for widespread dissemination. If the promise of the intervention is realized, it will reduce the high rates of morbidity and mortality associated with smoking. PUBLIC HEALTH RELEVANCE: Technological Innovations in a Behavioral Treatment for Cigarette Smoking Public Health Relevance Statement Cigarette smoking is the largest preventable risk factor for morbidity and mortality in the United States. The proposed treatment will integrate the reach and convenience of the internet with a state-of-the-art, empirically-derived behavioral treatment for cigarette smoking: abstinence reinforcement therapy. The current program is innovative and directly addresses some of the major limitations (cost, sustainability, dissemination) inherent in traditional abstinence reinforcement delivery models. The intervention has the potential to be appealing and feasible for widespread dissemination. As such, this technological innovation in a behavioral treatment for cigarette smoking holds significant promise as a way to reduce the high rates of morbidity and mortality associated with smoking.