Dynamic Processes of Smoking Cessation

描述(由申请人提供)：这是一项指导研究科学家发展奖(K01)的申请，以支持PI建立一条独立的研究路线，研究成瘾行为的一般原因，特别是吸烟的原因。培训目标将通过积极的指导研究计划以及正式的课程作业、研讨会、定向阅读和研讨会来实现，这些目标是：(1)开发使用生态瞬时评估(EMA)方法的专业知识，(2)开发健康行为理论(HBT)及其在戒烟方面的应用专业知识，(3)获得分析EMA数据的专门培训，以及(4)提高学术生产率。本研究旨在探讨吸烟结果期望(OES)在大学生戒烟中的作用。这项拟议的研究采用了密集的纵向准实验设计，使用EMA方法来捕捉正在尝试戒烟的大学生吸烟者吸烟结果预期的变化。其目的是描绘吸烟OES和戒烟的变化的时间顺序。相关的和横截面的支持表明，与现在的吸烟者相比，以前吸烟者中消极的吸烟者比积极的吸烟者更多。目前的证据缺乏一个时间上的具体描述，说明在戒烟过程中OES何时发生变化，以及OE的变化是否会像HBTS假设的那样导致行为变化，或者像认知不和谐理论(Festinger，1957)假设的那样，行为变化导致OES的变化。参与者(n=120)将在4周内自我监测吸烟行为和态度：基线(1周)，在此期间自然记录吸烟过程；戒烟前(1周)，从戒烟开始后开始；戒烟后(2周)，从戒烟当天开始；长期随访将在3个月后评估。为了促进戒烟，参与者将参加治疗(三次简短的建议会议，尼古丁替代疗法)。通过使用掌上电脑，使用基于事件和基于时间的抽样方法，每天报告几次。总而言之，K01奖项将使PI能够利用她现有的高级统计培训优势和理论驱动的健康行为干预经验，使她能够充分利用现代技术来描述戒烟过程中潜在的因果机制。 与公共健康相关：大学生吸烟是一个重大的公共健康问题。令人鼓舞的是，目前的证据表明，大学生吸烟者可能特别容易接受控烟干预，因为这一人群的吸烟模式似乎是流动的，因此潜在的可塑性特别强；同时，现代技术越来越多地允许在实时和现实生活中提供干预措施。了解OES在戒烟过程中所起的具体作用将有助于更准确、更及时地为这一人群量身定做干预材料。

DESCRIPTION (provided by applicant): This is a Mentored Research Scientist Development Award (K01) application to support the PI's establishment of an independent line of research examining the causal mechanisms of addictive behavior in general and smoking in particular. The training goals, which will be met through an active mentored research plan as well as formal coursework, seminars, directed readings, and workshops, are: (1) to develop an expertise in the use of Ecological Momentary Assessment (EMA) methodology, (2) to develop an expertise in health behavior theories (HBT) and their application to smoking cessation, (3) to acquire specialized training for the analysis of EMA data, and (4) to increase scholarly productivity. The purpose of the proposed research project is to examine the role of smoking outcome expectancies (OEs) in college student smoking cessation. The proposed study utilizes an intensive longitudinal quasi-experimental design using EMA methodology to capture changes in smoking outcome expectancies in college student smokers undergoing a quit attempt. The goal is to delineate the temporal ordering of changes in smoking OEs and smoking cessation. Correlational and cross-sectional support exists that demonstrates that negative OEs outweigh positive OEs in former smokers compared to current smokers. Missing from current evidence is a temporally specific delineation of when in the process of smoking cessation changes in OEs occur, and whether changes in OEs lead to behavior change, as HBTs postulate, or behavior change leads to changes in OEs, as Cognitive Dissonance Theory (Festinger, 1957) postulates. Participants (n=120) will self-monitor smoking behaviors and attitudes during 4 weeks: baseline (1 week), during which processes are naturalistically recorded, pre-quit (1 week), beginning after the onset of treatment, and post-quit (2 weeks), beginning on the quit day; long-term follow-up will be assessed 3-months later. To facilitate smoking cessation, participants will partake in treatment (three brief advice sessions, nicotine replacement therapy). Reports are made several times a day through the use of palm-top computers, using both event-based and time-based sampling approaches. Taken together, this K01 award would allow the PI to build upon her existing strengths of advanced statistical training and experience with theory-driven health behavior interventions to enable her to take full advantage of modern technology to delineate the causal mechanisms underlying the process of smoking cessation. PUBLIC HEALTH RELEVANCE: Smoking among college students represents a significant public health issue. Encouragingly, current evidence suggests that college student smokers may be particularly receptive to tobacco control interventions, as the pattern of smoking in this population appears to be fluid, and thus potentially particularly malleable; meanwhile, modern technology increasingly allows the delivery of interventions in real-time and real-life situations. Understanding the specific role OEs play in the process of cessation will allow the more accurate, time-sensitive tailoring of intervention materials for this population.