Feasibility of a Web-based Smoking Cessation Program for Vocational Students

描述(由申请人提供)：年轻人和社会经济地位(SES)最低的个人报告的香烟使用率最高，戒烟率最低。尽管来自低SES背景的年轻成年吸烟者与SES较高的同龄人一样有可能尝试戒烟，但他们不太可能使用有效的戒烟治疗，也不太可能真正戒烟。由于缺乏资源、帮助和/或支持，占据较低SES类别的个人可能无法使用有效的戒烟治疗。这些人也可能更喜欢自己戒烟，而不使用戒烟辅助工具。根据与戒烟相关的个人特征量身定做的网络戒烟计划是仅有的几种自我指导的戒烟计划之一，可以以非常低的成本接触到大量吸烟者。然而，使用定制的基于网络的程序检查戒烟的研究几乎完全集中在SES较高的白人女性吸烟者身上。这项研究的目的是研究为来自较低SES背景的不同种族/民族的年轻成年吸烟者量身定做的基于网络的戒烟计划的可行性。将通过随机将个人分配到基于社会认知理论和说服性沟通研究的定制网络戒烟计划或包括提供循证戒烟信息的非定制网络戒烟计划的控制条件来评估利用率和可接受性。这两个项目都将自行安排进度，允许个人选择何时何地访问它们。参与者将是参加中专后职业/技术计划的吸烟者，他们想要戒烟。建议项目的具体目标是：1)确定来自低SES背景的年轻成年吸烟者是否会使用量身定制的基于网络的戒烟计划，并认为它是一种可接受的戒烟方法；2)确定与来自低SES背景的年轻成年吸烟者相关的心理社会变量(例如，经济压力、角色负担、抑郁症状)，这些变量导致基于网络的计划的利用率和可接受性的变化；以及3)使用个人访谈来确定如何提高基于网络的定制戒烟计划的利用率和可接受性，并最大限度地吸引来自低SES背景的年轻成年吸烟者。如果成功，该项目将导致一项为期多年的R01提案，在一项更大的随机对照试验中测试定制的基于网络的戒烟计划的有效性。具体目标2和3的结果将被用来修改现有的基于网络的方案，以进一步调整其以适应较低社会经济地位类别的年轻人的需要。这项研究的长期目标是为来自低SES背景的年轻人开发有效的戒烟计划，最终将减少烟草使用方面的差异，以及与烟草相关的发病率和死亡率。 与公共卫生相关：在美国，烟草使用仍然是可预防的死亡的主要原因。年轻人和社会经济地位(SES)最低的个人在吸烟者中所占比例不成比例。确定能够覆盖、吸引和有效的低SES背景的大量吸烟者的低成本戒烟计划，将对减少吸烟差异以及与吸烟相关的发病率和死亡率产生重大影响。

DESCRIPTION (provided by applicant): Young adults and individuals in the lowest socioeconomic status (SES) categories report the highest rates of cigarette use and lowest rates of cessation. Although young adult smokers from backgrounds characterized by low SES are just as likely as their higher SES peers to attempt to quit smoking, they are less likely to use effective cessation treatments and less likely to actually quit. Individuals who occupy lower SES categories may not use effective cessation treatments due to lack of resources, assistance, and/or support. These individuals may also prefer to quit on their own, without the use of cessation aids. Web-based programs tailored to individual characteristics relevant to smoking cessation are one of the only types of cessation programs that are self-directed and can reach large numbers of smokers for very little cost. Yet, research examining smoking cessation using tailored web-based programs has focused almost exclusively on higher SES, White female smokers. The purpose of this study is to examine the feasibility of a tailored web-based cessation program for a racially/ethnically diverse sample of young adult smokers from lower SES backgrounds. Utilization and acceptability will be assessed by randomly assigning individuals either to a tailored web-based smoking cessation program based on social cognitive theory and studies of persuasive communications or to a control condition comprising a non-tailored web-based program providing evidence- based smoking cessation information. Both programs will be self-paced, allowing individuals to choose when and where they visit them. Participants will be smokers enrolled in post-secondary vocational/technical programs who want to quit smoking. The Specific Aims of the proposed project are to 1) Determine if young adult smokers from low SES backgrounds will use a tailored web-based cessation program and find it an acceptable means for quitting, 2) Identify the psychosocial variables relevant to young adult smokers from low SES backgrounds (e.g., financial stress, role overload, depressive symptoms) that contribute to variability in utilization and acceptability of the web-based program, and 3) Use individual interviews to determine how to increase utilization and acceptability of the tailored web-based program, and maximize its appeal to young adult smokers from low SES backgrounds. If successful, this project will lead to a multi-year R01 proposal testing the efficacy of a tailored web-based smoking cessation program in a larger randomized controlled trial. Results from Specific Aims 2 and 3 will be used to modify the existing web-based program to further tailor it to the needs of young adults occupying lower SES categories. The long-term goal of this research is to develop effective smoking cessation programs for young adults from low SES backgrounds that ultimately will decrease disparities in tobacco use and tobacco-related morbidity and mortality. PUBLIC HEALTH RELEVANCE: Tobacco use remains the leading cause of preventable death in the United States. Young adults and individuals occupying the lowest socioeconomic status (SES) categories are disproportionately represented among smokers. Identifying low-cost smoking cessation programs that can reach, appeal to, and are effective for large numbers of smokers from low SES backgrounds, will have a major impact on decreasing disparities in smoking and smoking-related morbidity and mortality.