Enhancing Quit and Win Contests to Improve Cessation Among College Smokers

描述（由申请人提供）：帮助年轻吸烟者戒烟是国家卫生优先事项，但很少有针对他们的循证治疗方法。迫切需要为年轻人制定和提供有吸引力和有效的戒烟干预措施。学院和大学招收了1400多万年轻人，是吸引相当大比例年轻人吸烟的理想场所。标准戒烟赢奖竞赛，即吸烟者通常戒烟一个月以换取赢取奖品的机会，实施简单，易于传播，在鼓励戒烟方面可能特别具有成本效益，至少在短期内是这样。这些比赛的许多特点似乎很适合在大学校园实施，但它们的总体效益受到短暂比赛期后复发吸烟的限制。这些发现证实了干预措施的必要性，比如这里提出的那些干预措施，旨在在最初的“戒烟赢”比赛期之后保持戒断。我们的目标是在基于理论的方法中评估增加剂量和增加内容的单独和联合效果，以增强大学校园戒烟和获胜参与者的戒断。首先，我们将通过将比赛次数从一个月延长到连续三个月的比赛来测试治疗剂量的效果。第二，我们将通过增加戒烟咨询来测试治疗的内容。我们的创新方法，动机性复发预防（MRP），侧重于增加内在动机和应对策略，以防止复发。我们建议在2年制和4年制大学校园中对吸烟者进行2 × 2因子随机对照试验（n = 1,256）。参与者将被随机分配到以下四个条件中的一个：Tx1)：标准戒烟和获胜竞赛（1个月）+学院健康（接触控制）咨询；Tx2)：标准戒赢大赛（1个月）+动机性复发预防（MRP）咨询；Tx3)：延长戒赢大赛（连续3个月）+学院健康（控制）咨询；Tx4)：延长戒赢大赛（连续3个月）+ MRP辅导。本研究将测试以下目标：所有咨询电话将在12周的干预期内通过6次电话管理会议提供，使用参与者敏感调度。主要结果将是在研究入组后9个月（即干预期结束后6个月）通过测量尿可替宁来验证30天的戒断。这项建议解决了一项迫切需要，即采取有吸引力和有效的干预措施，帮助年轻人戒烟。我们预计，在这项研究完成后，我们将确定具体的策略，以提高大学校园戒烟和获胜参与者的持续戒断率，这些结果将对全国高校的决策者和项目规划者产生极大的兴趣。公共卫生相关性：我们在本提案中的目标是在基于理论的方法中评估增加剂量和增强内容的单独和联合效果，以增强大学校园戒烟和获胜参与者的戒断。首先，我们将通过将比赛次数从一个月延长到连续三个月的比赛来测试治疗剂量的效果。其次，我们将通过增加戒烟咨询，动机性复发预防（MRP）来测试治疗内容，这是一种创新的咨询策略，侧重于增加内在动机和应对策略，以防止复发。在这项研究完成后，我们将确定具体的策略，以提高大学校园戒烟和获胜参与者的持续戒断率，并预计这些结果将对全国高校的决策者和项目规划者产生极大的兴趣。

DESCRIPTION (provided by applicant): Helping young smokers quit is a national health priority, but few evidence-based treatments are designed for them. Developing and delivering appealing and effective smoking cessation interventions for young people is critically needed. Colleges and universities, which enroll over 14 million young adults, are ideal settings to reach a substantial proportion of young adult smokers. Standard Quit & Win contests, in which smokers typically quit for one month in return for the opportunity to win prizes, are simple to implement and easy to disseminate and may be particularly cost-effective in encouraging cessation, at least short term. Many features of these contests appear well suited for implementation on college campuses, but their overall benefit is limited by relapse to smoking after the brief contest period. These findings confirm the need for interventions, such as those proposed here, designed to maintain abstinence beyond the initial Quit & Win contest period. Our objective in this proposal is to evaluate the separate and combined efficacy of increased dose and enhanced content within a theory based approach to enhance abstinence among college campus Quit and Win participants. First, we will test the effect of the dose of treatment by extending the number of contests from one month to three successive monthly contests. Second, we will test the content of treatment by adding cessation counseling. Our innovative approach, Motivational Relapse Prevention (MRP), focuses on increasing intrinsic motivation and coping strategies to prevent relapse. We propose a 2 x 2 factorial randomized controlled trial with smokers (n = 1,256) on 2- and 4-year college campuses. Participants will be randomized to one of four conditions: Tx1): Standard Quit and Win Contest (1 month) + College Health (Contact Control) Counseling; Tx2): Standard Quit and Win Contest (1 month) + Motivational Relapse Prevention (MRP) Counseling; Tx3): Extended Quit and Win Contest (3 successive monthly contests) + College Health (Control) Counseling; Tx4): Extended Quit and Win Contest (3 successive monthly contests) + MRP Counseling. This study will test the following aims: All counseling calls will be delivered via six telephone-administered sessions over the 12 week intervention period using participant sensitive scheduling. The primary outcome will be 30-day abstinence validated via urine cotinine measured 9 months after study enrollment (i.e., 6 months after the end of the intervention period. This proposal addresses a critical need for appealing and effective interventions to help young people to quit smoking. We anticipate that at the completion of this research we will have identified specific strategies for improving sustained abstinence rates among college campus Quit & Win participants and that these results will be of great interest to decision makers and program planners at colleges and universities nationwide. PUBLIC HEALTH RELEVANCE: Our objective in this proposal is to evaluate the separate and combined efficacy of increased dose and enhanced content within a theory based approach to enhance abstinence among college campus Quit and Win participants. First, we will test the effect of the dose of treatment by extending the number of contests from one month to three successive monthly contests. Second, we will test the content of treatment by adding cessation counseling, Motivational Relapse Prevention (MRP), an innovative counseling strategy focused on increasing intrinsic motivation and coping strategies to prevent relapse. At the completion of this research we will have identified specific strategies for improving sustained abstinence rates among college campus Quit & Win participants and anticipate that these results will be of great interest to decision makers and program planners at colleges and universities nationwide.