Real-Time Patterns of Smoking and Alcohol Use: A Daily Data Analysis

描述(由申请人提供)：吸烟和饮酒的实时模式：每日数据分析吸烟是美国可预防的死亡和残疾的主要原因1-3。尽管吸烟与癌症相关的发病率和死亡率之间有着密切的关系，而且戒烟4-7对健康有明显的好处，但每年都戒烟的人很少，在第一年戒烟的人中，有70%-95%的人会在第一年内戒烟。大量饮酒与吸烟10是高度共病的，也是癌症相关疾病和死亡率的重要风险因素11-13，还与持续吸烟有关。 戒烟的成功(或尝试)较少。近一半的问题饮酒者依赖尼古丁14，酒精和烟草的共同影响在增加癌症相关风险方面具有乘数效应。12、15戒烟的自我效能(SE)是戒烟结果的最重要决定因素之一。然而，SE如何变化的机制还不是很清楚。一个原因是，研究没有考虑到其他可能影响SE和吸烟之间的关联的因素，这些因素与吸烟行为特别相关，例如酗酒。拟议中的应用将通过在84名酗酒吸烟者样本中确定阻碍或促进SE和未来戒烟努力的日常变化因素来解决研究中的这一差距。参与者将使用创新的交互式语音应答(IVR)电话调查，每天两次跟踪他们的吸烟、饮酒和与吸烟相关的SE，为期28天。我们将根据这些日常因素预测未来戒烟结果(例如，每天减少吸烟、戒烟尝试和完全戒烟)在1个月和6个月内发生的可能性。到目前为止，研究还没有利用创新的方法来捕捉日常因素对戒烟结果的影响，也没有特别关注高风险的酗酒吸烟者，尽管他们与癌症相关的风险增加。一个有经验支持的模型描述了日常自尊如何调节日常饮酒和吸烟与未来戒烟结果之间的关系，这对于开发有效的戒烟干预措施至关重要。本R03与国家癌症研究所最近的举措一致：(A)使用创新的方法来确定可以作为新治疗目标的影响癌症相关风险的行为；(B)减少烟草使用和吸烟的流行率；(C)了解共病情况对癌症相关风险的影响；以及(C)为癌症研究培养新一代研究人员16-19。R03将为推动这些领域的发展提供强有力的基础，并开始回答许多仍然存在的问题，即高危群体如何启动和维持与癌症相关的危险行为的变化。这项研究的结果将对通过针对酗酒吸烟者的独特需求开发有针对性的戒烟干预措施来降低癌症相关风险和疾病的总体患病率具有重要的长期临床和公共卫生意义。

DESCRIPTION (provided by applicant): Real-time patterns of smoking and alcohol use: A daily data analysis Cigarette smoking is the leading cause of preventable death and disability in the United States1-3. Despite the strong relationship between smoking and cancer-related morbidity and mortality and the noted health benefits of quitting 4-7, very few smokers quit every year 8, and between 70%-95% of those who do quit relapse within the first year 9. Heavy drinking, which is highly co-morbid with cigarette smoking 10, also represents a significant risk factor for cancer-related illness and mortality11-13, and is also implicated in persistent smoking, and less success (or attempts) at quitting smoking. Nearly half of all problem drinkers are nicotine dependent 14, and the combined influence of alcohol and tobacco has a multiplicative effect on increasing cancer-related risk.12,15 Self-efficacy (SE) to abstain from smoking is one of the most important determinants of smoking cessation outcomes. However, the mechanism of how SE changes is not well understood. One reason is that studies have failed to take into account other factors that may influence associations between SE and smoking that are particularly relevant to smoking behavior, such as heavy drinking. The proposed application will address this gap in the research by identifying daily changing factors that impede or promote SE and future smoking cessation efforts in a sample of 84 heavy drinking smokers. Participants will track their smoking, alcohol consumption, and SE related to smoking twice a day for 28 days using innovative interactive voice response (IVR) telephone surveys. We will predict the likelihood of future smoking cessation outcomes (e.g., reduced cigarettes per day, cessation attempts, and complete abstinence) at 1- and 6-months follow-up from these daily factors. Research to date has not taken advantage of innovative methods that capture the impact of daily factors on smoking cessation outcomes, nor have they focused specifically on high-risk heavy drinking smokers, despite their elevated cancer-related risk. An empirically supported model describing how daily SE mediates the association between daily drinking and smoking to future cessation outcomes is crucial for developing effective smoking cessation interventions. This R03 is consistent with recent initiatives at the National Cancer Institute to: (a) use innovative approaches to identify behaviors that impact cancer-related risk that could be targeted in new treatments; (b) reduce tobacco use and the prevalence of cigarette smoking; (c) understand the impact of co-morbid conditions on cancer-related risk; and (c) prepare a new generation of investigators for cancer research16-19. This R03 would provide a strong basis for moving the field forward in these areas and to begin to answer many of the questions that remain about how high-risk groups initiate and maintain changes in cancer-related risk behaviors. Findings from this study will have important long-term clinical and public health significance in decreasing the overall prevalence of cancer-related risk and illness by developing targeted cessation interventions for the unique needs of heavy drinking smokers.