A brief behavioral intervention for co-users of marijuana (MJ) and tobacco among smokers calling state quitlines

项目摘要 在美国，每年有超过40万烟草使用者拨打国家资助的戒烟热线，寻求戒烟帮助。一个 最近的一项研究发现，在致电戒烟热线的人中，25%的人报告使用过大麻/大麻，44%的人报告说使用过大麻 其中有兴趣戒烟或减少大麻(MJ)使用的人(除了想戒烟外 烟草)。未知的是如何在这种情况下最好地帮助共同用户。我们提出了一种第一阶段的治疗方法 为正在寻求烟草成瘾治疗的大麻和烟草的共同使用者进行的研究。我们计划 调整现有的基于证据的针对大麻使用者的简短干预措施，并将其整合到烟草戒烟线中 咨询协议。大麻检查计划(MJCU)是一项以证据为基础的、简短的行为 对没有为MJ寻求治疗的MJ使用者进行干预。MJCU使用激励增强疗法， 一种帮助共同用户的动机访谈(MI)和认知行为(CBT)策略：1) 了解使用MJ的健康和行为后果，2)考虑改变其使用方式， 3)减少使用MJ的频率、数量和方式。理论结构(MI、CBT)和 两种治疗(QuiLine和MJCU)的传递方式(电话、网络和邮件)相似，因此是 这可能是一个很好的整合选择。我们将进行一项小型随机试点研究，招募了100名共同使用者 从四个州的退出线来确定整合的可行性、可接受性和初步有效性 干预性治疗与单纯标准戒断治疗的比较。结果将包括治疗参与度 (已完成呼叫)、对治疗的满意度、3个月后戒烟(生化验证)，以及 3个月后吸食大麻的结果。我们的方法使用机会主义的、现实世界的环境来提供大麻 为可能更愿意考虑减少大麻使用的联合使用者提供咨询服务，因为他们 戒烟动机和由于继续使用 大麻。拟议的针对共同使用的简短行为干预可能会增加QuiLine呼叫者的 实现并保持戒烟的机会，并增加他们减少大麻的动机 使用。这些发现将为共同使用者开发可扩展的公共卫生干预策略提供参考 跨多行实现。

PROJECT ABSTRACT In the U.S., over 400,000 tobacco users call state-funded quitlines each year for help with quitting smoking. A recent study found that 25% of those who call tobacco quitlines reported using marijuana/cannabis and 44% of those were interested in quitting or cutting back on their marijuana (MJ) use (in addition to wanting to quit tobacco). Unknown is how best to help co-users in this setting. We propose a Stage I treatment development study for co-users of marijuana and tobacco who are seeking treatment for tobacco addiction. We plan to adapt an existing evidence-based brief intervention for marijuana users and integrate it into tobacco quitline counseling protocols. The Marijuana Check-up program (MJCU) is an evidence-based, brief behavioral intervention for MJ users not seeking treatment for MJ. The MJCU utilizes motivational enhancement therapy, a form of motivational interviewing (MI), and cognitive behavioral (CBT) strategies to help co-users: 1) understand the health and behavioral consequences of using MJ, 2) consider making changes to their use, and 3) cut down on the frequency, quantity and methods of using MJ. The theoretical constructs (MI, CBT) and the mode of delivery (phone, web, and mail) are similar for both treatments (quitline and MJCU) and thus are potentially a good fit for integration. We will conduct a small randomized pilot study with 100 co-users recruited from four state quitlines to determine the feasibility, acceptability and preliminary effectiveness of the integrated intervention compared with the standard quitline treatment alone. Outcomes will include treatment engagement (calls completed), satisfaction with treatment, tobacco cessation at 3 months (biochemically verified), and marijuana outcomes at 3 months. Our approach uses an opportunistic, real-world setting to offer marijuana counseling services to co-users who may be more willing to consider reducing their marijuana use given their motivation to quit tobacco and the known risks of meeting tobacco cessation goals due to continued use of marijuana. The proposed brief behavioral intervention addressing co-use may increase quitline callers' chances of achieving and maintaining tobacco abstinence and increasing their motivation to reduce marijuana use. Findings will inform development of scalable public health intervention strategies for co-users easily implemented across quitlines.