Effectiveness of a Web-Assisted Quitline for Smokeless Tobacco Users

描述（由申请人提供）：许多美国人习惯使用无烟烟草（ST），并希望戒烟，但缺乏资源。需要创新的、经过验证的和易于交付的低成本干预措施来帮助性传播工具使用者戒烟。本项目利用机会研究了两种戒烟干预措施，这两种干预措施的使用越来越多，但仍需要更系统的评估：(1)使用互联网获取健康信息和戒烟已经越来越受欢迎，我们最近完成的研究（Chewfree.com）证明了网络提供的ST戒烟计划的有效性；(2)戒烟热线目前在美国所有50个州都有，并且在对吸烟者的实证研究中显示出良好的效果，它们被烟草使用者广泛使用。我们建议以ORI和UCSD两个互补且成熟的研究团队的工作为基础，测试将交互式网络干预与戒烟热线相结合的有效性，该热线为性行为戒烟提供电话咨询。我们计划使用2x2设计和2440名参与者来测试网络程序和电话咨询的个人主要效果，以及检查这些治疗方法相结合时的附加价值。结果测量包括在6个月的随访期间延长禁欲。除戒烟结果外，我们还将评估每种干预条件可能影响戒烟的中介过程。我们还将进行经济分析，以评估提供这些项目的相对成本效益。这将是第一个评估电话热线咨询对无烟烟草（鼻烟和嚼烟）戒烟效果的研究，也是第一个测试将网络辅助戒烟加入电话戒烟热线的相对价值的研究。电话咨询戒烟热线和基于网络的干预措施由于覆盖面广、人均成本相对较低以及在实证研究中取得了令人鼓舞的结果，正在成为戒烟方面重要的公共卫生干预措施。迄今为止，还没有对这些针对无烟烟草使用者的方法进行测试。通过寻求回答有关这些有前途的方法的个别和综合有效性的问题，并评估提供这些方案的相对成本，拟议的随机对照试验将有助于确定性传播疾病戒烟的最佳做法，并可以最大限度地提高其使用的公共卫生效益。

DESCRIPTION (provided by applicant): Many Americans engage in the habitual use of smokeless tobacco (ST) and wish to quit but lack the resources. There is a need for innovative, validated, and easily-delivered low cost interventions to help ST users quit using tobacco. This project takes advantage of the opportunity to study two tobacco cessation interventions that are growing in use but still need more systematic evaluation: (1) The use of the Internet for health information and tobacco cessation has been growing in popularity, and our recently-completed study (Chewfree.com) demonstrated the efficacy of a Web-delivered ST cessation program; (2) Tobacco quitlines are now available in all 50 states and have demonstrated promising results in empirical studies with smokers, and they are widely used by ST users. We propose to build on the work of two complementary and well- established research teams at ORI and UCSD to test the effectiveness of combining an interactive Web-based intervention with a quitline that provides telephone counseling for ST cessation. We plan to use a 2x2 design and 2,440 participants to test for the individual main effects of the Web program and phone counseling as well as to examine the added value when these treatment approaches are combined. Outcome measures include prolonged abstinence over a 6-month follow-up period. In addition to the tobacco cessation outcomes we will assess mediational processes through which each intervention condition may affect tobacco abstinence. We will also perform an economic analysis to evaluate the relative cost-effectiveness of offering these programs. This will be the first study to assess the efficacy of telephone helpline counseling for smokeless tobacco (snuff and chewing tobacco) cessation and also the first to test the relative value of adding Web-assisted cessation to a telephone quitline. Because of their broad reach, relatively low cost per user, and their promising results in empirical studies, both telephone counseling quitlines and Web-based interventions are emerging as important public health interventions for tobacco cessation. To date there has not been a test of these approaches when targeted to smokeless tobacco users. By seeking to answer questions about the individual and combined effectiveness of these promising approaches, and assessing the relative cost of delivering these programs, the proposed randomized controlled trial will help define best practices for ST cessation and could maximize the public health benefits of their use.