Social Cognitive Theory and Nondaily Smoking, Escalation and Desistance

描述（由申请人提供）：该研究计划的长期目标是制定针对轻度吸烟者的戒烟计划，这些轻度吸烟者最有可能发展为每日吸烟。最近的证据表明，轻度和间歇性吸烟（LITS）的流行率急剧增加。LITS增加了发病率和死亡率，许多间歇性吸烟者发展为风险更高的每日吸烟。之甚少 已知与LITS相关的因素，或赋予过渡到日常吸烟的风险，或促进过渡到不吸烟。在LITS中，吸烟行为可能是基于强化而不是缓解戒断。大多数戒烟计划都是基于身体依赖模型，因此对非日常吸烟者可能不太有效。LITS以及其他尼古丁和烟草产品的使用在年轻人群中最常见。这一提议在概念上基于社会认知理论（SCT），该理论认为行为决策是由认知因素决定的，如自我效能、结果预期和行为意图;这些因素受到社会环境的影响。我们假设吸烟模式的变化将与这些结构以及它们如何随时间变化有关。本研究的目的是：（1）纵向研究LITS的稳定性与过渡到日常和非吸烟;（2）检验SCT模型是否预测吸烟阶段转变的概率，（3）评估SCT效应是否受个性和环境因素的调节，和（4）检验使用其他尼古丁和烟草产品会增加从LITS进展为每日吸烟的风险的假设。我们的目标是分析哪些变量在纵向吸烟结果中发挥作用，并评估解释这些影响的机制。这项拟议中的研究将有助于更好地了解间歇性吸烟者成为日常吸烟者和非吸烟者的机制，并与奥巴马总统强调预防负面健康结果的观点一致。这些数据可能对预防和治疗具有重要意义。通过确定促进向日常吸烟和非吸烟过渡的风险和保护因素，我们希望为明确针对间歇性吸烟者及其吸烟动机的干预措施的发展奠定基础。

DESCRIPTION (provided by applicant): The long-term goal of the program of research of which this proposal is part is the development of tobacco cessation programs targeted at light smokers at greatest risk for progressing to daily smoking. Recent evidence suggests the prevalence of light and intermittent smoking (LITS) has increased dramatically. LITS increases morbidity and mortality, and many intermittent smokers progress to riskier daily smoking. Little is known about factors that are associated with LITS, or that confers risk for transition to daily smoking, or promotes transition to non-smoking. With LITS, smoking behavior may be based on reinforcement rather than alleviation of withdrawal. Most cessation programs are based on a physical dependence model, and may therefore be less effective for non-daily smokers. LITS, as well as use of other nicotine and tobacco products, is most common in younger populations. This proposal is conceptually based in Social Cognitive Theory (SCT), which posits that behavioral decisions are determined by cognitive factors such as self-efficacy, outcome expectancies, and behavioral intentions; these are influenced by the social environment. We hypothesize that changes in smoking patterns will be associated with these constructs and how they change over time. The purpose of the proposed research is to: (1) longitudinally examine LITS stability versus transitions to daily and non-smoking; (2) to test whether the SCT model predicts the probability of smoking stage transitions, (3) to evaluate whether SCT effects are moderated by personality and environmental factors, and (4) to test the hypothesis that use of other nicotine and tobacco products potentiates the risk of progression from LITS to daily smoking. Our goal is to analyze which variables play a role in longitudinal smoking outcomes and to assess mechanisms that explain these effects. The proposed research will lead to a better understanding of mechanisms by which intermittent smokers become daily and non-smokers, and is consistent with President Obama's emphasis on prevention of negative health outcomes. These data may have important implications for prevention and treatment. By identifying risk and protective factors that promote transition to daily and non-smoking, we hope to lay the groundwork for the development of interventions that explicitly target intermittent smokers and their smoking motives.