Evaluation of a brief tobacco intervention in the US military

虽然军方在过去20年里采取了减少烟草使用的措施，但超过四分之一的新 新兵报告入伍前经常使用烟草和尼古丁产品(TNCP)。 这一比率高于21.3%的美国成年人的全国患病率。17简短的健康预防计划可能是 考虑到所有飞行员都已经戒烟11年半了，在技术培训中对飞行员特别有效 几周和近三分之二的人相信他们不会回到TNCP。我们已经开发并验证了23个 简要烟草干预(BTI)，目前正在作为技术培训的一部分实施。我们发现 以激励性访谈为基础的40分钟BTI在增加感知到的伤害和 在1055名空军实习生样本中减少使用三氯甲烷的意向。尽管我们获得了重要的 烟草行为潜在认知结构的积极变化对未来TNCP有很高的预测作用 在年轻人和年轻人中使用，24-29 Little等人的研究没有获得实际恢复TNCP的措施 在禁止在空军训练中使用TNCP之后。鉴于所有TNCP恢复/启动的69.8%发生在 技术培训，18有必要进行一项研究，评估我们的BTI对实际使用TNCP的短期影响 在进行全面的R01之前，这将评估BTI干预的长期疗效。因此， 我们提出了以下具体目标：(1)初期招收约2000名空军实习生 在11周半的时间里，在德克萨斯州圣安东尼奥-拉克兰空军联合基地进行技术培训 非自愿戒烟禁令；(2)随机安排参与者：(A)接受我们的吸烟军人 量身定做的小册子(HL095758)，飞行员保持无烟指南(飞行员指南；有 (B)《飞行员指南+简明烟草》 干预(BTI)；(3)确定短期(3个月，技术培训结束)的疗效 对TNCP戒断的干预。我们的主要成果是在技术培训结束时进行TNCP戒断 以确定估计的效果大小，并为后续的R01建立必要的前期工作。 鉴于其中一个军种每年有超过22万名新兵入伍，30公众 针对最常用的三氯甲烷的有效的短暂烟草干预对健康的影响 军事人员在技术训练中占有相当大的比例。如果BTI被证明是有效的，它可以很容易地 在技术培训期间向有类似禁烟令的其他服务部门传播。

While the military has taken steps to reduce tobacco use over the past two decades, over a quarter of new military recruits report regular tobacco and nicotine containing product (TNCP) use prior to enlistment.2 This rate is higher than the national prevalence of 21.3% of US adults.17 Brief health prevention programs may be particularly effective for Airmen in Technical Training, given that all Airmen have been tobacco free for 11 ½ weeks and nearly 2/3rds are confident that they won't return to TNCPs. We have developed and validated23 a Brief Tobacco Intervention (BTI) that is currently being implemented as part of Technical Training. We found that a motivational interviewing based, 40 minute BTI was efficacious in increasing perceived harm and decreasing intentions to use TNCPs in a sample of 1055 Air Force trainees. Although we obtained significant positive changes in latent cognitive constructs for tobacco behavior that are highly predictive of future TNCP use in youth and young adults,24-29 the Little et al study did not obtain measures of actual TNCP resumption following the ban on TNCPs in Air Force training. Given that 69.8% of all TNCP resumption/initiation occurs in Technical Training,18 a study that evaluates the short-term impact of our BTI on actual TNCP use is necessary prior to conducting the full scale R01 that would evaluate the long term efficacy of the BTI intervention. Thus, we propose the following Specific Aims: (1) To recruit approximately 2,000 Air Force trainees at the beginning of Technical Training at Joint Base San Antonio-Lackland Air Force in San Antonio, TX during the 11 ½ week involuntary cessation ban; (2) To randomize participants to either (a) receive our cigarette smoking military tailored pamphlet (HL095758), The Airmen's Guide to Remaining Tobacco Free (Airmen's Guide; which has been disseminated and is now the standard of care in the Air Force) or (b) the Airmen's Guide + Brief Tobacco Intervention (BTI); (3) To determine the short-term (3 month, end of Technical Training) efficacy of the intervention on TNCP abstinence. Our primary outcome is TNCP abstinence at the end of Technical Training to determine an estimated effect size as well as establish the requisite preliminary work for a subsequent R01. Given that over 220,000 new recruits enter the military annually in one of the service branches,30 the public health implications of an effective brief tobacco intervention targeting the most commonly used TNCPs for military personnel in Technical Training is considerable. If the BTI is proven efficacious it can be easily disseminated to other service branches that have similar tobacco bans during Technical Training.