Mobile Mindfulness for Smoking Cessation

描述(由申请人提供)：在美国，吸烟是首要的可预防的死亡原因。许多因素促成了戒烟的挑战，包括负面情绪和压力诱导的渴望导致吸烟的联想学习过程，以及每天都会因吸烟行为而多次强化的获得性反应。已经开发了许多行为干预措施来治疗吸烟，但成功率仍然很低。我们最近发现，专门针对压力、渴望和习得反应的群体正念训练，与美国肺脏协会的自由戒烟等其他行为疗法相比，戒烟率翻了一番。我们还发现了专注力训练(MT)的潜在机制：将渴望和吸烟之间的联系脱钩。然而，基于临床小组的治疗费用昂贵，由于治疗师经验的多样性和坚持手工培训，交付很难标准化。移动电话应用程序的最新进展导致了基于APP的戒烟干预，可以降低成本并优化标准化交付。为了加强MT的交付，我们已经将我们针对吸烟的手动MT翻译成了智能手机应用程序(渴望戒烟，C2Q)。此外，我们已经将其与一个在线社区配对，该社区可以提供同行支持和专家指导。在这项拟议的研究中，主要目的将评估移动正念训练(C2Q)的效果。为了实现这一目标，1200名吸烟者将被随机接受C2Q或国家癌症研究所的NCIQuitPal。主要终点是在治疗开始后6个月自我报告的7天点戒断率。次要目标1将是评估C2Q计划的短期效果。次要终点将包括在治疗开始后3个月的7天点流行禁欲。次要目标2将是确定C2Q使用与3个月和6个月戒烟之间的关系。C2Q程序的使用情况，通过(1)完成的模块数量，(2)完成的非正式正念练习的数量，以及(3)访问在线社区的次数进行回归分析，以确定他们预测C2Q组吸烟的程度。这项拟议的研究为社会提供了潜在的好处。首先，这项研究将测试成本效益高的戒烟疗法C2Q的疗效。其次，这项研究将检验假想的结果预测因素，这将提高我们对戒烟的理解和治疗。

DESCRIPTION (provided by applicant): Smoking is the leading preventable cause of death in the U.S. A number of factor contribute to the challenge of quitting smoking, including the associative learning process whereby negative affect and stress-induced craving lead to smoking, and learned responses that are reinforced multiple times daily by smoking behavior. Many behavioral interventions have been developed to treat smoking, but success rates remain low. We have recently found that group-based mindfulness training, which specifically targets stress, craving and the learned responses, doubles abstinence rates compared to other behavioral treatments such as the American Lung Association's Freedom From Smoking. We have also found potential mechanisms for mindfulness training (MT): the decoupling of the link between craving and smoking. However, clinic group-based treatments are expensive and delivery is difficult to standardize due to variability in therapist experience and adherence to manualized training. Recent advances in mobile-phone applications have led to app-based interventions for smoking cessation that can reduce costs and optimize standardized delivery. To enhance delivery of MT, we have translated our manualized MT for smoking into a smartphone application (Craving To Quit, C2Q). Further, we have paired this with an online community, which can provide peer support and expert guidance. In the proposed study, The Primary Aim will assess the efficacy of mobile mindfulness training (C2Q). To achieve this, 1200 smokers will be randomized to receive C2Q, or The National Cancer Institute's NCIQuitPal. The primary endpoint will be self-reported 7-day point prevalence abstinence at 6 months after treatment initiation. Secondary Aim 1 will be to assess the short-term efficacy of the C2Q program. Secondary endpoints will include 7-day point prevalence abstinence at 3 months after treatment initiation. Secondary Aim 2 will be to determine the relationship between C2Q usage and tobacco abstinence at 3 and 6 months. C2Q program usage, measured by (1) the number of modules completed, (2) the amount of informal mindfulness practice completed, and (3) the number of visits to the online community will be used in regression analyses to determine the degree to which they predict smoking in the C2Q group. The proposed study provides potential benefits for society. First, this study will test the efficacy of a cost-effective treatment for smoking cessation, C2Q. Second, this study will test hypothesized predictors of outcomes which will improve our understanding and treatment of smoking cessation.