Internet Based Voucher Reinforcement for Smoking Cessation

描述(由申请人提供)：基于互联网的戒烟凭证强化：烟草使用仍然是美国发病率和死亡率的头号可预防原因。没有其他人口的吸烟流行率和问题比农村人口更明显和明显，农村人口获得治疗的机会有限。目前的戒烟干预措施是适度有效的，这表明需要更密集、更创新和更容易获得的治疗方法。基于代金券的戒断强化疗法是一种高度密集的方法，患者赚取货币代金券，这些代金券可以根据有记录的戒酒情况换取商品和服务。为了提高想要戒烟的吸烟者接受这种强化治疗的可及性，开发了一种新的基于凭证的戒烟强化疗法，其中经常通过互联网监测和加强吸烟状况。通过这种基于互联网的干预，可以收集吸烟者提供一氧化碳样本的实时视频，并验证其吸烟状态。然后，根据患者经核实的吸烟状况，向他们提供反馈和加强。这种创新的方法可能非常适合需要可获得的强化戒烟干预的农村吸烟者。这项拨款申请建议进行探索性研究，以适应、实施和评估一种新的基于互联网的凭证强化干预措施，用于肯塔基州农村重度吸烟者的戒烟。建议进行一项试点研究，将肯塔基州的农村吸烟者(N=80)随机分配到两组中的一组：临时代金券组和非临时代金券组。在为期6周的时间里，将使用基于互联网的CO监测系统，每天从所有参与者那里收集和验证两次CO样本。分配到临时代金券组的参与者如果提供CO样本&lt；4ppm，将获得货币代金券。非或有凭证组的参与者将收到与其CO样本无关的凭单。总体而言，本申请提出了一项研究，旨在为农村社区重度吸烟者开发和评估一种强化的、可获得的戒烟干预措施，并为未来的研究提供经验依据。

DESCRIPTION (provided by applicant): Internet-Based Voucher Reinforcement for Smoking Cessation: Tobacco use continues to be the number one preventable cause of morbidity and mortality in the United States. In no other population are the prevalence rates and problems of smoking more apparent and pronounced than those in rural populations, where access to treatment is limited. Current smoking cessation interventions are modestly effective, which suggest the need for therapies that are more intensive, innovative, and accessible. Voucher-based abstinence reinforcement therapy is a highly intensive approach wherein patients earn monetary vouchers that can be exchanged for goods and services contingent on documented abstinence. To improve the accessibility of this intensive therapy to smokers who want to quit smoking, a novel voucher based abstinence reinforcement therapy for smoking has been developed wherein smoking status is frequently monitored and reinforced via the internet. With this internet based intervention, real-time video of smokers providing CO samples are collected and verified for smoking status. Patients are then provided feedback and reinforcement based on their verified smoking status. This innovative approach may be well suited for rural smokers who are in need of accessible intensive smoking cessation interventions. This grant application proposes exploratory research to adapt, implement, and evaluate a novel internet based voucher reinforcement intervention for smoking cessation in heavy smokers in rural Kentucky. A pilot study is proposed in which rural smokers in Kentucky (N=80) will be randomly assigned to one of two groups: contingent vs. noncontingent vouchers group. For 6 weeks, CO samples will be collected and verified twice daily from all participants using an internet based CO monitoring system. Participants assigned to the contingent vouchers group will receive monetary vouchers if they provide a CO sample <4ppm. Participants in the noncontingent vouchers group will receive vouchers independent of their CO sample. Overall, the application proposes research to develop and evaluate an intensive and accessible smoking cessation intervention for heavy smokers in rural communites, and provide the empirical basis for future research.