This application is a revision of a competing renewal of a collaborative smoking cessation program between the University of Memphis, the University of Minnesota, and the United States Air Force (HL-53478). We propose to extend a unique opportunity to offer a smoking cessation maintenance intervention in a population of underserved smokers who have already quit smoking for a six-week period (but are at lower risk for complete relapse). In an initial three year period, we have been successful in assessing over 32,000 Basic Military Training (BMT) recruits, randomized 75% to intervention and 25% control, delivered interventions to nearly 26,000 of these recruits, and have six week test-retest reliability on approximately 7,000 subjects. All baseline data are entered, cleaned, and with a total of only 10 missing data points. Currently, 12-month follow-up data are being finalized from troops who are now all over the globe; we have completed surveying 100% of smokers at baseline and have conducted a random sample of baseline non-smokers. Follow-up rates t one year exceed 95% of participants. Evaluation data to date suggest a clinically significant difference in point prevalent abstinence (3.0%), given a """"""""low impact"""""""" and cost-effective intervention. Intervention effects are larger in women (relative to men) and minorities (relative to Euro Americans). Interventions developed, if found to be efficacious, will continue by members of the U.S. Air Force in the future (i.e., complete dissemination). The current proposal has a number of unique methodological strengths: (1) It offers a tailored intervention in an underserved population at risk for smoking relapse, smoking onset, and smokeless tobacco use; (2) It allows randomization of virtually an entire population over a one- year period to a specialized intervention versus standard care. Thus, sampling bias is greatly reduced in this design; (3) It ensures that 100% of those assigned to specialized intervention or standard intervention or standard care will receive it. (4) The participation rate will be extremely high in this study; loss to follow-up will be minimal; and (5) We will be able to test the long-term effectiveness of our tailored intervention in a population of individuals who have quit all tobacco use for six weeks at the time of our extended maintenance intervention. Given this introduction, we propose the following Specific Aims: (1) To enhance our validated smoking cessation program by strengthening key elements of the program and by lengthening the program in Basic Military Training (BMT); (2) To validate and implement an intense, tailored smoking prevention program for non-smokers in BMT who are at high risk for smoking onset; and (3) To validate and implement a tailored smokeless tobacco intervention in a population with a high baseline rate of smokeless tobacco use.
Showing the most recent 10 out of 12 publications
