Relapse-Prevention Booklets as Adjunct to a Tobacco Quitline

预防复发小册子作为戒烟热线的辅助工具 项目摘要 吸烟是导致癌症和冠心病的主要可预防原因， 癌症导致过早死亡的主要原因。因此，预防这些疾病的巨大潜力在于 努力实现长期戒烟。为了应对这一公共卫生挑战，烟草 现在，美国每个州都建立了戒烟“退出热线”，最近的荟萃分析表明， 与对照组相比，戒烟热线提供的服务大大提高了戒烟率。 不幸的是，戒烟的特点是随后复发率高，大约 95%的戒烟者在尝试戒烟后一年内复发。复发率略低于 那些在正式的计划中接受治疗的人，例如退出线，但规范是绝大多数人 吸烟者在某个时候会重新吸烟。以前的研究发现，一系列的8永远 向最近戒烟的人邮寄免费的预防复发小册子， 通过至少2年的随访，吸烟复发，这种干预措施具有很高的成本效益。 由于这些发现，NCI推广和分发了《永远免费》小册子。然而，在这方面， 这些结果是基于对自我选择的前吸烟者的有效性试验，这些人通过反应性试验招募， 招聘战略。一项关于永久免费预防复发小册子的对照有效性试验， 打电话到州戒烟热线的人将测试干预对更普遍的戒烟者群体的影响。 此外，鉴于最近戒烟线使用的增长，有效的最低限度干预，以防止复发， 在使用戒烟热线戒烟的个人中，将具有极高的公共卫生意义。 这项拟议中的研究是开发预防复发药物的研究人员之间的合作， 干预，在H。位于佛罗里达坦帕的李·莫菲特癌症中心以及与纽约 位于纽约布法罗的罗斯威尔公园癌症研究所的州戒烟热线（NYSSQL）是最繁忙的戒烟热线之一。 在美国退出。大约3400名戒烟者将被随机分配到三种情况之一， 两周后的电话回访。三分之一将被随机分配到家庭护理（UC）条件，这将 定期接受戒烟热线服务。三分之一将被随机分配到重复邮寄（RM）条件， 将在12个月内定期收到8本永久免费小册子。第一 第三个将被随机分配到批量邮寄（MM）条件，该条件将在一个单一的时间内收到所有8本小册子。 在付邮主要的具体目标是（1）测试自助，预防复发的有效性 干预（永远免费小册子）作为一个国家的电话戒烟线的辅助;（2）比较两个不同的 小册子分发时间表已在以前的研究支持;（3）计算和 比较干预措施的成本效益。这样一项有效性研究代表了以下方面的最后一步： 在通过国家退出线广泛传播之前，干预措施的制定和验证是合理的。

Relapse-Prevention Booklets as Adjunct to a Tobacco Quitline Project Summary Tobacco smoking is the leading preventable cause of cancer and coronary heart disease, and it is the primary cause of premature death due to cancer. Thus, great potential for prevention of these diseases lies with efforts toward long-term cessation of smoking. In response to this public health challenge, tobacco cessation "quitlines" have now been developed in every US state, and recent meta-analyses indicate that the services provided by quitlines significantly improve cessation rates compared to control conditions. Unfortunately, smoking cessation is characterized by high rates of subsequent relapse, with approximately 95% of self-quitters relapsing within a year of their cessation attempt. Relapse rates are slightly less among those receiving treatment in a formalized program, such as a quitline, yet the norm is that the vast majority of smokers will at some point relapse back to smoking. Previous research has found that a series of 8 Forever Free relapse-prevention booklets mailed to individuals who recently quit smoking significantly reduces rates of smoking relapse through at least 2 years of follow-up, and that this intervention is highly cost-effective. Because of these findings, the Forever Free booklets have been promoted and distributed by NCI. However, these results were based on efficacy trials with self-selected former smokers who were recruited via reactive recruitment strategies. A controlled effectiveness trial of the Forever Free relapse-prevention booklets with callers to a state quitline would test the effect of the intervention on a more general population of quitters. Moreover, given the recent growth in quitline usage, an effective minimal intervention to prevent relapse among individuals who quit smoking using a quitline would have extremely high public health significance. The proposed study is a collaboration between researchers who developed the relapse-prevention intervention, at the H. Lee Moffitt Cancer Center in Tampa, Florida, and those associated with the New York State Smokers' Quitline (NYSSQL), at Roswell Park Cancer Institute in Buffalo, New York, one of the busiest quitllines in the US. Approximately 3400 quitline clients will be randomized to one of three conditions at the point of their 2-week follow-up call. One-third will be randomized to a Usual Care (UC) condition, which will receive regular quitline services. One-third will be randomized to a Repeated Mailings (RM) condition, which will receive the 8 Forever Free booklets sent by mail at regular intervals over a period of 12 months. And one- third will be randomized to a Massed Mailings (MM) condition, which will receive all 8 booklets in a single mailing. The primary specific aims are (1) to test the effectiveness of a self-help, relapse-prevention intervention (Forever Free booklets) as an adjunct to a state telephone quitline; (2) to compare two different booklet distribution schedules that have been supported in previous research; and (3) to calculate and compare the cost-effectiveness of the interventions. Such an effectiveness study represents the final step in intervention development and validation before widespread dissemination via state quitlines can be justified.