? This application is a revision of a competing renewal of a collaborative smoking cessation intervention program between the University of Tennessee, the University of Minnesota, and the United States Air Force. Cigarette smoking is the number one preventable cause of morbidity and mortality in this nation. Active duty military personnel are at high risk for cigarette smoking, but represent an often neglected and underserved group. Smoking rates among active duty personnel range from approximately 26% for the U.S. Air Force to nearly 40% for Marines. Moreover, since the 9/11 tragedy and subsequent military incursions into Afghanistan and Iraq, the prevalence of smoking in the military has increased, while smoking in the civilian population has continued to decline. Of further concern is that this increase is most prevalent in young military personnel, ages 18-25. Despite strong efforts by the Department of Defense (DoD) to reduce tobacco use, rates of smoking in the military remain high. There are unique challenges in the military, including high mobility of troops, remote locations, and limited access to healthcare services. Many intervention programs that show strong efficacy in civilian populations often show limited or no efficacy in military populations (see Significance). As such, validating new and promising programs in military populations is important. A promising and widely disseminated approach to the treatment of tobacco dependence on a population-wide basis is the use of Tobacco Quit Lines (QL). Given that QL interventions can address the issues of mobility and remote access present in the military (particularly during periods of what the armed services call """"""""high operations tempo"""""""" [i.e. war-like conditions]), validating the efficacy of QLs in military populations is a high priority. Thus, the goals of the current project are as follows: To determine the long-term (one-year) efficacy of the intervention conditions in participants (n=2158) randomly assigned to a Proactive versus Reactive QL. Our exploratory aims include determining the representativeness of our sample relative to the population of Air Force personnel and to determine if measures of social cognitive theory relate to program adherence and outcome. ? ? ?
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