Take a Break: mHealth-assisted skills building challenge for unmotivated smokers

 描述(申请人提供)：在美国，吸烟仍然是主要的可预防的死亡原因，大多数吸烟者在任何给定的时间都不准备戒烟。在此R01应用程序中，我们提出了创新的“休息一下”项目，这是一项利用NRT采样和可访问且引人入胜的移动健康技术的戒烟诱导试验，包裹在游戏的概念中。在戒烟研究中，大多数证据适用于少数吸烟者，即那些积极戒烟的人。这一已知的差距是显著的，因为大多数吸烟者--那些没有准备戒烟的人，也被描述为分阶段戒烟框架中的吸烟者--历史上并不是戒烟干预的重点。休息包括三周的短暂体验，在此期间为吸烟者提供尼古丁替代疗法；给予游戏；鼓励尝试短暂的戒烟；奖励参与的认可点数；并允许继续使用该技术。这款游戏包括用来评估吸烟行为和烟瘾并提供即时反馈的挑战赛问题，以及一套在需要时可用来帮助培养应对技能的工具。我们假设，与纯NRT组相比，休息组在休息期间有更多的禁欲天数，在休息结束时自我效能感有更大的提高，第一次停止尝试的时间更短，以及更高的戒断率 6个月后就辞职了。如果休息一下被证明是有效的，它就有很大的潜力进行广泛的、非传统的传播。我们的具体目标是目标1：完善休息mHealth工具和实施方案。目的2：对休息的有效性进行随机试验。目的3：对AIM-2随机临床试验的参与者进行为期6个月的跟踪，以评估戒烟尝试的时间、戒烟尝试的次数以及经过生化验证的6个月流行点数。休息干预旨在提高动机阶段吸烟者的自我效能感和支持新技能。它还将提供对这一吸烟者群体的宝贵洞察，并增加我们对哪些工具可能有效地帮助他们戒烟的理解。

 DESCRIPTION (provided by applicant): Smoking continues to be the major preventable cause of mortality in the United States, and the majority of smokers are not ready to quit at any given time. In this R01 application, we propose the innovative "Take a Break" project, a smoking cessation induction trial utilizing NRT-sampling and accessible and engaging mobile health technology, wrapped in concepts of a game. In smoking cessation research, the majority of evidence applies to the minority of smokers, those actively quitting. This known gap is significant because the majority of smokers - those who are not ready to quit smoking, also described as smokers in the "Motivation Phase" of the Phased Framework of Smoking Cessation, historically have not been the focus of cessation interventions. Components of Take a Break include a brief 3-week experience during which smokers are provided nicotine replacement therapy; given the game; encouraged to try a brief period of abstinence; rewarded with recognition points for participation; and allowed continued access to the technology. The game includes Challenge Questions to assess smoking behavior and cravings and provide immediate feedback, and a suite of tools available at the point of need to help develop coping skills. We hypothesize that, compared with the NRT-only group, the Take a Break group will have a greater number of days abstinent during the `break' period, a greater increase in self-efficacy at the end of the `break' period, a lower time to first quit attempt, and a higher rate of quit at 6 months. If Take a Break proves to be effective, it has great potential for widespread, non- traditional dissemination. Our Specific Aims are AIM 1: Refine the Take a Break mHealth tool and implementation program. AIM 2: Conduct a randomized trial of the effectiveness of Take a Break. AIM 3: Follow participants in the AIM 2 randomized clinical trial for 6 months to evaluate time to quit attempts, number of quit attempts, and 6-month biochemically verified point prevalent cessation. The Take a Break intervention is designed to increase self-efficacy and support new skills for Motivation Phase smokers. It also will provide valuable insight into this population of smokers and increase our understanding of which tools may be effective in helping them quit smoking.