Cognitive Behavioral Smoking Cessation Intervention for Adults with Chronic Pain

成人慢性疼痛的认知行为戒烟干预

• 批准号: 7779964
• 负责人: W. Michael Hooten
• 金额: $ 18.7万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7779964
• 关键词: Abstinence; Adult; Affective; Anxiety; Behavioral; Clinic; Clinical; Clinical Trials; Cognitive; Cognitive Therapy; Cotinine; Data; Development; Distress; Environment; Focus Groups; Future; Health; Health Personnel; Healthcare Systems; Individual; Institution; Intervention; Interview; Manuals; Mental Depression; National Institute of Drug Abuse; Nurses; Opioid; Outcome; Outpatients; Pain; Patient Self-Report; Phase; Population; Professional counselor; Provider; Randomized; Randomized Clinical Trials; Rehabilitation therapy; Research; Research Methodology; Research Project Grants; Saliva; Self Efficacy; Severities; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking Status; Staging; Testing; Theoretical model; Tobacco; Training; Work; base; brief intervention; chronic pain; design; improved; informant; meetings; multidisciplinary; non-smoker; novel; programs; public health relevance; smoking cessation; social cognitive theory; standard of care; therapy design; therapy development; treatment center; treatment program

DESCRIPTION (provided by applicant): While millions of adults with chronic pain smoke, little is known about the associations between chronic pain and smoking cessation. Helping individuals with chronic pain to stop smoking is important in that pain- related outcomes are worse for smokers compared to nonsmokers with chronic pain. However, our preliminary data suggests that currently available smoking cessation interventions may not be effective for smokers with chronic pain, indicating the need for an intervention designed specifically for these individuals. The conceptual basis for this proposal is social cognitive theory. The primary aim of this research project is to develop a cognitive behavioral smoking cessation intervention for specific use in an outpatient clinical setting where smokers are receiving treatment for chronic pain. Secondary aims include examination of the mechanisms of change from baseline to end of treatment associated with the cognitive behavioral intervention based on our theoretical model, including self-efficacy, depression, pain-related affective distress, and pain-related anxiety. The project will be conducted in two phases. In Phase I, we will employ participatory research methods to develop a cognitive behavioral smoking cessation intervention for specific use in an outpatient practice environment for chronic pain. The participatory research methods will utilize informant interviews and focus groups involving individuals with chronic pain and health care providers with expertise in chronic pain and smoking cessation. This work will also involve development of a treatment manual, training of nurse counselors with expertise in smoking cessation and chronic pain, and pilot testing with 10 smokers. Phase 2 will consist of a clinical trial utilizing a randomized, two-group design with repeated assessment of smoking status at weeks 4 and 26. Smokers with chronic pain will be randomly assigned to receive the newly developed cognitive behavioral smoking cessation intervention (N = 30) or a brief smoking cessation intervention (N = 30), which is the current standard of care at our institution. The brief smoking cessation intervention was used in our preliminary study and no individual with chronic pain quit smoking. Self-report smoking cessation at weeks 4 and 26 will be biologically confirmed using a saliva cotinine kit. At project conclusion, the multidisciplinary team will have developed a smoking cessation intervention designed for dissemination to a general ambulatory population of smokers with chronic pain. PUBLIC HEALTH RELEVANCE: Millions of individuals with chronic pain smoke and our preliminary research suggest that currently available strategies to help people quit smoking may not be effective for individuals with chronic pain. This is important in that smokers with chronic pain have worse pain-related health outcomes compared to nonsmokers with chronic pain. The primary aim of this research project is to develop a smoking cessation intervention for specific use in an outpatient clinical setting for smokers with chronic pain.

描述（由申请人提供）：虽然数百万患有慢性疼痛的成年人对慢性疼痛和戒烟之间的关联知之甚少。与慢性疼痛的非吸烟者相比，帮助慢性疼痛的人停止吸烟很重要。但是，我们的初步数据表明，目前可用的戒烟干预措施对慢性疼痛的吸烟者可能没有有效，这表明需要专门为这些人设计的干预措施。该提议的概念基础是社会认知理论。该研究项目的主要目的是开发一种认知行为戒烟干预措施，以在门诊临床环境中进行特定用途，在该环境中，吸烟者正在接受慢性疼痛的治疗。次要目的包括检查基于理论模型的认知行为干预措施的变化机制，包括自我效能，抑郁，与疼痛有关的情感困扰和与疼痛有关的焦虑。该项目将分为两个阶段。在第一阶段，我们将采用参与性研究方法来开发认知行为戒烟干预措施，以在门诊练习环境中特定用于慢性疼痛。参与性的研究方法将利用线人访谈和焦点小组，涉及具有慢性疼痛和医疗保健提供者的个人，并具有慢性疼痛和戒烟方面的专业知识。这项工作还将涉及制定治疗手册，对戒烟和慢性疼痛专业知识的护士辅导员的培训以及10名吸烟者的试点测试。第2阶段将包括使用随机的两组设计的临床试验，并在第4周和第26周重复评估吸烟状态。慢性疼痛的吸烟者将被随机分配，以接收新开发的认知行为戒烟干预（n = 30）或简短的吸烟戒烟干预（N = 30），这是我们Intercation Careistion的标准标准。我们的初步研究中使用了短暂的戒烟干预措施，没有慢性疼痛的人戒烟。使用唾液Cotinine试剂盒将在生物学上确认在第4和26周的自我报告戒烟。在项目结论中，多学科团队将开发出一种吸烟干预措施，旨在传播给慢性疼痛的一般卧铺人群。 公共卫生相关性：数百万患有慢性疼痛烟雾的人和我们的初步研究表明，目前可以帮助人们戒烟的可用策略可能对患有慢性疼痛的人没有有效。这一点很重要，因为与慢性疼痛的非吸烟者相比，患有慢性疼痛的吸烟者的健康状况较差。该研究项目的主要目的是开发一种戒烟干预措施，以在门诊临床环境中为患有慢性疼痛的吸烟者使用。

项目成果

Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.

• DOI: 10.1097/j.pain.0000000000000170
• 发表时间: 2015-06
• 期刊: Pain
• 影响因子: 7.4
• 作者: Hooten WM;Lamer TJ;Twyner C
• 通讯作者: Twyner C

Smoking cessation and chronic pain: patient and pain medicine physician attitudes.

• DOI: 10.1111/j.1533-2500.2011.00462.x
• 发表时间: 2011-11
• 期刊: Pain practice : the official journal of World Institute of Pain
• 作者: Hooten WM;Vickers KS;Shi Y;Ebnet KL;Townsend CO;Patten CA;Warner DO
• 通讯作者: Warner DO

A cognitive behavioral smoking abstinence intervention for adults with chronic pain: a randomized controlled pilot trial.

• DOI: 10.1016/j.addbeh.2013.11.010
• 发表时间: 2014-03
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Hooten WM;Townsend CO;Hays JT;Ebnet KL;Gauvin TR;Gehin JM;Laures HJ;Patten CA;Warner DO
• 通讯作者: Warner DO