Personalized Prevention: Smoking Cessation in Lung Nodule Patients

项目总结 将计算机断层扫描(CT)用于肺癌筛查的医学评估导致了 越来越多的患者被诊断为肺混浊或肺“结节”。肺结节患者 患肺癌的风险很高；对于目前吸烟的人来说，戒烟是最重要的策略 可用于降低患肺癌的风险。到目前为止，还没有关于肺结节戒烟的研究。 患者，他们可能有独特的特征(例如，对结节与烟草相关的焦虑 有必要进行研究，开发最有效的戒烟干预措施。 因此，我们设计并建议评估两种新的行为干预措施，作为 药物疗法。干预1基于对增益框架消息的大量研究 促进戒烟，在这种情况下，将专门为患者设计和个性化戒烟 有肺结节的，以提高戒烟率。干预2是基于我们的研究结果，即戒烟 导致健康生物标记物(皮肤类胡萝卜素、血浆胆红素)的改善，这些信息可以 反馈给参与者以防止复发并促进较长期的戒断。具体地说，我们将注册和 将276名患有肺结节的患者随机分为干预1组，包括个性化视频和打印 干预，强调戒烟的好处(收益框架)，以评估这一假设 将在8周内提高戒烟率，超过戒烟治疗的标准。 然后我们将对干预2进行第二次随机化，这是一种个体水平的生物反馈干预 检查这一干预措施将在6个月后减少吸烟的假设。此外，我们建议 评估戒烟对人血清中microRNA图谱的影响，特别是对 Let-7家族microRNAs的水平，以更好地了解吸烟的生物学机制 戒烟降低了肺癌的促进性，并探索了戒烟的另一个潜在的生物标志物。血液/DNA 也将被存入银行，以支持未来基于生物标记物的研究。总体而言，该项目旨在开发 可转移的干预措施，以提高短期和长期戒烟率在这一未被研究的高- 风险患者人群，同时也评估涉及烟草致癌的机制，具有明确的 翻译潜力。

PROJECT SUMMARY The use of computed tomography (CT) for medical evaluation for lung cancer screening has resulted in a growing number of patients identified with pulmonary opacities, or lung "nodules". Patients with lung nodules are at heightened risk of lung cancer; for those who currently smoke, cessation is the most important strategy available to reduce lung cancer risk. To date, there has been no research on tobacco cessation in lung nodule patients, who may have unique attributes (e.g., anxiety about having a nodule coupled with tobacco dependence) that warrant research for the development of maximally effective tobacco cessation interventions. We thus have designed and propose to evaluate 2 novel behavioral interventions as adjuncts to pharmacotherapy. Intervention 1 is based on a large body of research on gain-framed messages for promotion of smoking cessation, which in this case will be designed and personalized specifically for patients with lung nodules, to increase rates of quitting. Intervention 2 is based on our findings that tobacco cessation leads to improvements in health biomarkers (skin carotenoids, plasma bilirubin), and this information can be fed back to participants to prevent relapse and promote longer-term cessation. Specifically, we will enroll and randomize 276 patients with lung nodules to Intervention 1, consisting of a personalized video and print intervention, emphasizing the benefits (gain-framed) of quitting smoking, to evaluate the hypothesis that this will improve tobacco quit rates above and beyond standard of care smoking cessation treatment over 8 weeks. Then we will perform a second randomization to Intervention 2, an individual-level, biofeedback intervention to examine the hypothesis that this intervention will reduce smoking at 6 months. In addition, we propose to evaluate the impact of smoking cessation on microRNA profiles in human serum, with particular interest in levels of the let-7 family of microRNAs, to better understand the biological mechanisms by which smoking cessation reduces lung tumor promotion and to explore another potential biomarker of cessation. Blood/DNA will also be banked to support future biomarker-based studies. Overall, this project aims to develop transferable interventions to improve short- and longer-term smoking cessation rates in this understudied high- risk patient population, while also evaluating mechanisms involving tobacco carcinogenesis, with clear translational potential.