Enhancing the Efficacy of a Smoking Quit Line in the Military

提高军队戒烟热线的有效性

• 批准号: 8913260
• 负责人: Robert C Klesges
• 金额: $ 72.54万
• 依托单位: UNIVERSITY OF TENNESSEE HEALTH SCI CTR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8913260
• 关键词: Abstinence; Address; Adopted; Air; Centers for Disease Control and Prevention (U.S.); Cigarette; Coast Guard; Confidence Intervals; Development; Funding; Goals; Health; Health Promotion; Health Services Accessibility; Human Resources; Intervention; Literature; Location; Marines; Methods; Military Personnel; Nature; Odds Ratio; Participant; Population; Prevalence; Professional counselor; Randomized; Recruitment Activity; Recycling; Relapse; Research; Services; Smoker; Smoking; South Korea; Standardization; State Government; Surveys; Telephone; Testing; Time; Tobacco; Tobacco use; Trust; Underserved Population; War; Work; acronyms; arm; cigarette smoking; disorder prevention; follow-up; high risk; interest; intervention program; nicotine replacement; operation; programs; quitline; reduce tobacco use; smoking cessation; success

DESCRIPTION (provided by applicant): In the cigarette smoking intervention literature, one of the most widely adopted and disseminated interventions are telephone tobacco quit lines (QLs).While QLs are efficacious, cessation rates are modest and relapse is marked. To date, no studies have evaluated methods of re-engaging smokers who call QLs that either fail to quit smoking or relapse. Our survey of QLs serving all 50 states revealed that QLs encourage one of two methods for reengagement for those that have relapsed or who failed to quit on their target quit date: (1) Re- initiate the entire QL intervention (Recycle); or (2) reduce the number of cigarettes per day (i.e., Rate Reduction) with the ultimate goal of quitting. Despite widespread use of these reengagement interventions, no empirical evidence exists supporting either these treatment reengagement strategies in tobacco QLs. The focus of this application is to extend our research with our validated tobacco QL in the military. Our rationale includes the fact that military personnel have among the highest rates of cigarette use in the U.S. Active duty military personnel are at high risk for smoking, but represent an underserved population. Smoking rates among active duty personnel range from 26% to 40%, depending on the service branch. Unique challenges to reducing tobacco use in the military exist, including high personnel mobility, remote locations, and limited healthcare service access. Many efficacious stop-smoking programs in civilian populations do not demonstrate efficacy when evaluated in a military population. In our previous funding period, we have documented that our military-tailored QL was associated with extremely high rates of sustained smoking cessation. Our military proactive QL produced superior cessation rates at a one year follow-up compared to a reactive QL. But similar to civilian QLs, we observed marked decay of sustained cessation rates from the end of treatment to the one year follow-up. An opportunity exists to reengage smokers who relapse or fail to quit by the end of QL treatment. As mentioned above, civilian QLs use Recycling and Rate Reduction as the primary method for treatment reengagement. Unfortunately these methods of reengaging the relapsed/failed to quit smoker have not been systematically evaluated. As such, we propose to randomize participants who relapse or fail to quit by the end of the intervention to either (1) repeating the proactive QL (Recycle); (2) smoking reduction with the goal of eventual cessation (Rate Reduction); or (3) the choice of Recycle or Rate Reduction (Choice). Efficacy will be established by assessing both point prevalence and continuous abstinence at a 12 month follow-up. While QL targeted to the military for ultimate dissemination is needed, our findings should be nonetheless generalizable to all tobacco QLs.

描述（由申请人提供）：在吸烟干预文献中，最广泛采用和传播的干预措施之一是电话戒烟热线（QL）。虽然 QL 有效，但戒烟率较低且复吸明显。迄今为止，还没有研究评估重新吸引吸烟者的方法，这些吸烟者称其戒烟失败或复吸。我们对服务于所有 50 个州的 QL 进行的调查显示，QL 鼓励那些已经复发或未能在目标戒烟日期戒烟的人重新参与两种方法之一：(1) 重新启动整个 QL 干预（回收）； (2) 减少每天吸烟的数量（即减少吸烟量），最终目标是戒烟。尽管这些重新参与干预措施得到广泛使用，但没有经验证据支持烟草质量水平中的这些治疗重新参与策略。 该应用的重点是利用我们在军队中经过验证的烟草 QL 来扩展我们的研究。我们的理由包括这样一个事实：军人是美国吸烟率最高的军人之一。现役军人的吸烟风险很高，但他们代表的是得不到充分服务的人群。现役人员的吸烟率从 26% 到 40% 不等，具体取决于服务部门。减少军队中的烟草使用存在独特的挑战，包括人员流动性大、地点偏远和医疗服务获取有限。许多对平民有效的戒烟计划在军队中进行评估时并未显示出有效性。 在我们之前的资助期间，我们记录了我们的军事定制生活质量与极高的持续戒烟率相关。与反应性 QL 相比，我们的军事主动 QL 在一年的随访中产生了更高的戒烟率。但与民用 QL 类似，我们观察到从治疗结束到一年随访期间持续戒烟率显着下降。 在 QL 治疗结束时，有机会重新吸引复吸或未能戒烟的吸烟者。如上所述，民用 QL 使用回收和降低率作为重新参与治疗的主要方法。不幸的是，这些重新吸引复吸/戒烟失败者的方法尚未得到系统评估。因此，我们建议将在干预结束时复发或未能戒烟的参与者随机分配为（1）重复主动 QL（回收）； (2) 以最终戒烟为目标的减少吸烟量（Rate Reduction）； (3) 选择回收或降低率（选择）。将通过评估 12 个月随访时的点流行率和持续戒断情况来确定疗效。 虽然需要针对军队的 QL 进行最终传播，但我们的研究结果应该适用于所有烟草 QL。