Preventing Relapse Following Involuntary Smoking Abstinence

描述（由申请人提供）：吸烟是这个国家发病率和死亡率的头号可预防原因8，9。对于那些试图戒烟的人来说，预防复吸是一个高度优先事项，因为大多数试图戒烟的人都会在很短的时间内复吸10。在接受正式戒烟计划的吸烟者中，至少有70%的人复发;在自我戒烟者中，复发率约为90%。然而，绝大多数试图戒烟的吸烟者在没有或只有很少的帮助的情况下做到了这一点。随着这一领域直接转向强调传播，戒烟热线和互联网干预等基于人口的方法越来越普遍13-15 16。虽然绝大多数吸烟者都试图自己戒烟，但令人惊讶的是，很少有关于减少戒烟者复吸的研究。布兰登和他的同事6，17 7已经证明，一系列的8个印刷自助小册子一贯产生较高的点流行率戒烟的吸烟者已经戒烟自己。鉴于这种方法对公共卫生的巨大影响，显然需要更多关于促进长期自我戒烟的研究。几乎所有关于促进自我戒烟的研究都是在参与者在参与干预措施之前自愿戒烟的样本中进行的6，7。然而，对于预防非自愿禁欲后复发的方法一无所知（例如，军事训练，住院期间，监狱，监狱和精神病院）。先前的研究1，2已经确定，在没有其他干预的情况下，军队中的长期非自愿戒烟与显着的长期戒烟率相关（一年随访时为15- 20%）。由于据我们所知，没有研究成功地干预，以减少复发率后，长期的非自愿戒烟，我们的具体目标如下：（1）招募约5200名美国空军（USAF）新兵在结束基本军事训练（BMT）谁是经常吸烟者之前，8周的非自愿戒烟期间BMT;（2）将参与者随机分配至（a）标准强制戒烟，（B）强制戒烟+印刷材料（在先前的研究中证明在自愿戒烟者中有效），（c）强制戒烟+3次主动预防复发电话，或（d）强制戒烟+印刷材料+ 3次主动预防复吸电话，采用2x2析因设计（印刷材料是与否与主动电话治疗交叉，是与否）。(3)确定戒烟维持干预的长期（12个月）疗效。我们的主要结果是在12个月的随访中保持戒烟。次要结局是6个月随访时的戒烟维持。

DESCRIPTION (provided by applicant): Cigarette smoking is the number one preventable cause of morbidity and mortality in this nation 8, 9. Preventing relapse is a high priority for those attempting to quit smoking as most people who attempt cessation relapse within a very short period of time 10. Of smokers who receive a formal cessation program, at least 70 percent relapse 10; among self-quitters, the relapse rate is approximately 90 percent 11. It is the case, however, that the vast majority of smokers who try to stop smoking do so with no or with minimal assistance 12. Population-based approaches such as tobacco quit lines and internet interventions are becoming increasingly more prevalent 13-15 16 as the field moves directly towards an emphasis on dissemination. While the vast majority of smokers try to quit on their own, surprisingly little research has been conducted on reducing relapse among self-quitters. Brandon and colleagues 6, 17 7 have demonstrated that a series of 8 printed self-help booklets consistently produced higher point-prevalence abstinence rates in smokers that had quit on their own. Given the enormous public health implications of this approach, more research on promoting long-term self-quitting is clearly needed. Virtually all research to date on promoting self-quitting has been conducted in samples where participants have voluntarily stopped smoking prior to participating in the interventions 6, 7. However, nothing is known about methods of preventing relapse following involuntary abstinence (e.g., military training, during hospital stays, in jails, prisons, & psychiatric facilities). Previous research 1, 2 has determined that protracted involuntary cessation in the military with no other intervention is associated with significant long-term cessation rates (15- 20 percent at a one-year follow-up). Since, to our knowledge, no study has successfully intervened to reduce relapse rates following a protracted involuntary abstinence, our specific aims are as follows: (1) To recruit approximately 5200 United States Air Force (USAF) recruits at the end of Basic Military Training (BMT) who were regular smokers prior to an 8-week involuntary cessation during BMT; (2) To randomize participants either to (a) standard forced cessation, (b) forced cessation + printed materials (proven to be efficacious in previous studies among those who voluntarily quit on their own), (c) forced cessation + 3 proactive relapse prevention telephone calls, or (d) forced cessation + printed materials + 3 proactive relapse prevention telephone calls, in a 2 x 2 factorial design (printed materials yes vs. no crossed with proactive telephone treatment, yes vs. no). (3) To determine the long-term (12 month) efficacy of the cessation maintenance intervention. Our primary outcome is smoking cessation maintenance at the 12 month follow-up. The secondary outcome is smoking cessation maintenance at the 6 month follow-up.