Smoking Cessation in Persons with Mental Health Conditions: Exploring the Role of Family and Friends

PA-20-251 Ruth L.Kirschstein国家研究服务奖(NRSA)个人博士后 促进健康相关研究多样性的奖学金(家长F31-多样性)。有精神障碍的吸烟者 健康状况(MHC)增加了死于肺部和心血管疾病的风险。吸烟率 在患有MHC的人群中，MHC的发病率远远高于普通成年人。不过，这些吸烟者 他们对戒烟感兴趣，戒烟率比一般人群低得多。影响戒烟的因素 对这些吸烟者来说，障碍包括支持吸烟的社会规范和社交网络的态度/行为 成员，药物治疗和行为策略的使用不足，烟草治疗不一致 精神卫生服务提供者的依赖。因此，领先的研究人员呼吁采用创新的方法来 解决MHC携带者的吸烟差异。基于家庭/同伴的行为干预可以是一种 创新和有效的方法，以吸烟者为目标的MHC有几个原因。家庭/同龄人影响 吸烟行为，它们在健康行为改变中的重要性是众所周知的。家庭/同龄人经常 MHC患者寻求和获得卫生服务的主要资源。一个小但稳定的身体 文献表明，家庭/同龄人可能会影响患有MHC的吸烟者的戒烟行为。家庭/同龄人 可以加强其他戒烟干预措施，如采用药物疗法。然而，干预措施 试图利用家人/同龄人的支持来实现长期戒烟的努力一直表现不佳。知识 我们对家庭/同龄人影响吸烟行为的机制的理解也存在差距 如何让家人/同龄人参与吸烟者的戒烟努力。由社会影响领域指导，如所述 在理论领域框架中，我的论文将解决这些已知空白。我的具体目标 目的是：1)前瞻性地研究家庭/同伴对吸烟者戒烟的影响。 MHC使用来自全国烟草与健康人口评估(PATH研究)的数据 对美国非制度化个人的代表性调查，参与者每年接受采访，2) 评估吸烟者的特征、家庭/同伴影响和戒烟之间的关系 患有MHC的吸烟者使用结构方程模型，以及3)定性地探索社会和临床障碍 戒烟促进者以及在患有MHC和精神疾病的吸烟者中纳入家庭/同伴支持 医疗保健提供者。这项工作与拟议的培训相结合，将有助于我发展成为一名 独立研究科学家，致力于开展烟草预防和控制的研究。我 将由一支在所有相关领域拥有专业知识的优秀指导团队提供支持：戒烟， 心理健康、实施科学和生物统计学。我的研究直接满足了NHLBI的目标 更好地了解人口健康差异的原因，并确定有效应对的战略 这些差异。

PA-20-251 Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research (Parent F31-Diversity). Smokers with mental health conditions (MHC) have increased risk of dying from lung and cardiovascular disease. The smoking rate among people with MHC greatly exceeds the rate in the general adult population. Although, these smokers are interested in quitting, their quit rates are much lower than the general population. Factors that act as quitting barriers for these smokers, include pro-smoking social norms and attitudes/behaviors of social network members, underuse of pharmacotherapies and behavioral strategies, and inconsistent treatment of tobacco dependency of mental health providers. Thus, leading researchers have called for innovative approaches to address smoking disparities in people with MHC. Family/peer-based behavioral interventions can be an innovative and effective approach to target smokers with MHC for several reasons. Family/peers influence smoking behaviors, and their importance in health behavior change is well-established. Families/peers are often a principal resource for persons with MHC in seeking and accessing health services. A small but consistent body of literature suggests that family/peers may influence the cessation behavior of smokers with MHC. Family /peers could augment other cessation interventions such as adoption of pharmacotherapies. However, interventions that attempt to harness family/peer support for long-term smoking cessation have underperformed. Knowledge gaps exist in our understanding of the mechanisms through which family/peers affect smoking behaviors, as well as how to involve family/peers in smokers’ cessation efforts. Guided by the social influence domain, as outlined in the Theoretical Domains Framework, my dissertation will address these knowlegde gaps. My specific aims are to: 1) prospectively examine the effect of family/peer influences on smoking cessation among smokers with MHC using data from the Population Assessment of Tobacco and Health (PATH study), a nationally representative survey of US non-institutionalized individuals in which participants are interviewed annually, 2) evaluate relationships between smokers’ characteristics, family/peer influences, and smoking cessation among smokers with MHC using Structural Equation Models, and 3) qualitatively explore social and clinical barriers and facilitators to smoking cessation and inclusion of family/peer support among smokers with MHC and mental health care providers. This work in combination with the proposed training will facilitate my development into an independent research scientist committed to conducting research focused on tobacco prevention and control. I will be supported by an outstanding mentoring team with expertise in all the relevant areas: smoking cessation, mental health, implementation science, and biostatistics. My research directly addresses NHLBI’s objective of better understanding the causes of population health differences and identifying strategies to effectively address these differences.