Smoking Cessation Self-Help for Dual Users of Tobacco Cigarettes and E-Cigarettes

 描述(申请人提供)：虽然电子烟(电子烟)进入市场还不到十年，但自2008年以来，使用量每年翻一番，预计2014年销售额将达到22亿美元。此外，传统烟草行业已经进入这个市场，预计未来将有更大的增长。对电子烟的研究仍在进行中 在初级阶段，他们的健康后果，成瘾风险，以及作为戒烟工具的潜力都有待商榷。电子烟不受监管，因此不能公开营销，作为治疗烟草依赖的药物疗法，然而调查研究发现，使用电子烟的主要动机是帮助戒烟或减少吸烟。尽管数百万吸烟者同时使用电子烟(双重吸烟者)，通常是为了戒烟，但他们通常在没有接受任何行为帮助的情况下这样做。尽管使用者的意图，双重使用可能保持烟草依赖，允许尼古丁在禁止吸烟时传递，同时使双重使用者暴露在与长期使用电子烟相关的额外的、迄今未知的健康风险中。有机会帮助大量双重吸烟者--已经通过开始使用电子烟表现出初步戒烟行动的吸烟者--戒烟并最终戒烟。这一自然发生的、自我选择的和积极的群体可能会从最小限度的干预中受益，这可能会增加他们实现和保持烟草和尼古丁戒断的机会。本申请的主要目的是：(1)通过系统的、形成性的过程调整有效的自助戒烟干预措施，以满足当前双重使用者的需要；(2)在2500名双重使用者的随机对照试验(RCT)中测试这一新干预措施；以及(3) 计算干预措施的成本效益。我们之前的研究已经证明，一系列自助小册子可以促进戒烟，减少复发。我们将针对双用户调整此干预。在随机对照试验中，新的干预措施将与不接受治疗(仅限评估)和现有的非针对性戒烟手册进行比较。随访将在注册后24个月进行，结果将包括戒烟和戒烟。第二个目标是收集关于烟草和电子烟使用模式的纵向数据，以及在双重使用者中停止使用这两种产品的过程。这个项目测试军民两用的高风险行为是否可以被资本化，以便于 戒烟，并最终停止所有尼古丁产品。

 DESCRIPTION (provided by applicant): Although electronic cigarettes (e-cigarettes) have been on the market for less than a decade, use has been doubling each year since 2008, and sales are projected to reach $2.2 billion in 2014. Moreover, the traditional tobacco industry has moved into this market, projecting greater growth in the future. Research on e- cigarettes is still in the nascent stage, with open questions about their health consequences, addiction liability, and potential as a smoking cessation tool. E-cigarettes are not regulated-and therefore cannot be overtly marketed-as pharmacotherapy for treating tobacco dependence, yet survey research has found that the primary motivations for their use are to aid smoking cessation or smoking reduction. Although millions of tobacco smokers are simultaneously using e-cigarettes (dual users), often for the purpose of quitting smoking, they usually do so without receiving any behavioral assistance. Despite users' intentions, dual use may maintain tobacco dependence by allowing nicotine delivery when smoking is prohibited, while simultaneously exposing dual users to additional, as-yet-unknown health risks associated with chronic e-cigarette use. The opportunity exists to assist the large population of dual users-smokers who have already demonstrated initial action toward smoking cessation by commencing use of e-cigarettes-with smoking cessation and eventual e- cigarette cessation. This naturally-occurring, self-selected, and motivated group may be ideally primed to benefit from a minimal intervention that may enhance their chances of achieving and maintaining tobacco and nicotine abstinence. The primary aims of the present application are: (1) to adapt via a systematic, formative process a validated self-help, smoking-cessation intervention to meet the needs of current dual users; (2) to test this new intervention in a randomized controlled trial (RCT) of 2500 dual users; and (3) to calculate the cost- effectiveness of the intervention. Our previous research has demonstrated that a series of self-help booklets can enhance smoking cessation and reduce relapse. We will adapt this intervention for dual users. In the RCT, the new intervention will be compared to both no-treatment (assessment-only) and existing, non-targeted smoking cessation manuals. Follow-up will occur through 24 months post-enrollment, and outcomes will include both cigarette and e-cigarette cessation. A secondary aim is to gather longitudinal data regarding the patterns of tobacco and e-cigarette use and the course of cessation of either product among dual users. This project tests whether the high-risk behavior of dual use can be capitalized upon to facilitate smoking cessation and, ultimately, cessation of all nicotine products.