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Grant Details

Grant Number: 5R01CA106668-05 Interpret this number
Primary Investigator: Williams, Geoffrey
Organization: University Of Rochester
Project Title: Self-Determination and Maintaining Tobacco Abstinence
Fiscal Year: 2008
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Abstract

DESCRIPTION (provided by applicant): This application (RFA # OB-03-003) extends our examination of self-determination theory (SDT) based counseling interventions to the issue of maintained abstinence from tobacco use. Two projects are proposed, both of which build on the results of our current trial. The first is a 32-month follow-up of the smoking status of patients in the current trial. The SDT intervention was effective at 6 months relative to community care, and, according to preliminary analyses, was also effective for maintenance at 18 months, but long-term (32-month) follow-up data are needed. The second project is a 3-cell clinical trial. The current results show that patients were four times more likely to quit by 6 months if they used medications known to be efficacious for cessation, so the trial will examine two extensions of the current intervention, both of which place greater emphasis on use of, and adherence to, cessation medications. The two arms will be compared to community care. Both arms involve two visits with a physician to discuss medications and side effects. In both interventions, counselors will address medication adherence. The two arms differ in that patients not ready to quit in one arm will receive a smoking reduction approach (with medications) in which they first try to reduce their smoking to half and then attempt cessation. In addition to greater emphasis on medications and examination of medication adherence as a mediator of maintained cessation, there will be two major changes in the intervention intended to facilitate long-term maintenance. First, the intervention will extend over 12 months (whereas the current one lasts only 6 months) with meetings during the additional time focusing on maintenance and relapse prevention. Second, at least one family member or best friend of each patient will be encouraged to meet with a counselor to learn how to be more autonomy supportive with the patient around issues related to tobacco. Our current results show that family autonomy support predicts cessation, and family members represent an important source of support for long-term maintenance of abstinence. Cessation and maintained abstinence will be examined with logistic regression and survival curve analyses. The SDT process model of maintained cessation will be tested using structural equation modeling, and cost-effectiveness analyses will be done for the interventions.

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Publications

Cost-effectiveness of intensive tobacco dependence intervention based on self-determination theory.
Authors: Pesis-Katz I, Williams GC, Niemiec CP, Fiscella K
Source: Am J Manag Care, 2011 Oct 1;17(10), p. e393-8.
EPub date: 2011 Oct 1.
PMID: 21999719
Related Citations

Grant Numbers:
NCI NIH HHS - R01-CA106668 NCI NIH HHS - R01 CA106668 NIMH NIH HHS - R01 MH059594
NIMH NIH HHS - R1-MH59594

MeSH Terms:
United States Tobacco Use Disorder Humans
Cost-Benefit Analysis Smoking Cessation Insurance, Health
Adult Personal Autonomy

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The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence.
Authors: Williams GC, Patrick H, Niemiec CP, Ryan RM, Deci EL, Lavigne HM
Source: Contemp Clin Trials, 2011 Jul;32(4), p. 535-43.
EPub date: 2011 Mar 5.
PMID: 21382516
Related Citations

Grant Numbers:
NIMH NIH HHS - R01 MH059594-04 NIMH NIH HHS - R01 MH059594-04S1 NIMH NIH HHS - R01 MH059594-04S2
NIMH NIH HHS - R01 MH059594-03S1 NIMH NIH HHS - R01-MH059594 NCI NIH HHS - R01-CA106668
NCRR NIH HHS - UL1RR024160 NCRR NIH HHS - M01-RR00044 NCI NIH HHS - R01 CA106668-02
NCRR NIH HHS - UL1 RR024160 NCI NIH HHS - R01 CA106668-03 NCI NIH HHS - R01 CA106668-04
NCI NIH HHS - R01 CA106668-05 NIMH NIH HHS - R01 MH059594-01 NIMH NIH HHS - R01 MH059594-02
NCI NIH HHS - R01 CA106668-01 NIMH NIH HHS - R01 MH059594-03

MeSH Terms:
Risk Reduction Behavior Motivation Psychological Theory
Humans Smoking Cessation Adult
Health Behavior Personal Autonomy Comparative Effectiveness Research
Adolescent Clinical Protocols

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The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence.
Authors: Williams GC, Niemiec CP, Patrick H, Ryan RM, Deci EL
Source: Ann Behav Med, 2009 Jun;37(3), p. 315-24.
EPub date: 2009 Apr 17.
PMID: 19373517
Related Citations

Grant Numbers:
NIMH NIH HHS - R01 MH059594-04 NCI NIH HHS - R01-CA106668 NIMH NIH HHS - R01-MH59594
NCI NIH HHS - R01 CA106668-05

MeSH Terms:
Psychotherapy Tobacco Use Disorder Psychological Theory
Humans Adult Treatment Outcome
Practice Guidelines as Topic Mental Competency Personal Autonomy
Tobacco Use Cessation

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Aspiring to physical health: the role of aspirations for physical health in facilitating long-term tobacco abstinence.
Authors: Niemiec CP, Ryan RM, Deci EL, Williams GC
Source: Patient Educ Couns, 2009 Feb;74(2), p. 250-7.
EPub date: 2008 Oct 5.
PMID: 18838243
Related Citations

Grant Numbers:
NIMH NIH HHS - R01 MH059594-04 NIMH NIH HHS - R01 MH059594-04S1 NIMH NIH HHS - R01 MH059594-04S2
NIMH NIH HHS - R01 MH059594-03S1 NCI NIH HHS - R01-CA106668 NIMH NIH HHS - R01-MH59594
NCI NIH HHS - R01 CA106668-02 NCI NIH HHS - R01 CA106668-03 NCI NIH HHS - R01 CA106668-04
NCI NIH HHS - R01 CA106668-05 NIMH NIH HHS - R01 MH059594-01 NIMH NIH HHS - R01 MH059594-02
NCI NIH HHS - R01 CA106668-01 NIMH NIH HHS - R01 MH059594-03

MeSH Terms:
Goals Questionnaires Self Care
Psychological Theory Humans Linear Models
Outcome Assessment (Health Care) Smoking Patient Education as Topic
Logistic Models Patient Participation Smoking Cessation
Health Behavior Social Support Follow-Up Studies
Program Evaluation Personal Autonomy Aspirations (Psychology)
Prevalence

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Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will?
Authors: Ryan RM, Deci EL
Source: J Pers, 2006 Dec;74(6), p. 1557-85.
PMID: 17083658
Related Citations

Grant Numbers:
NCI NIH HHS - CA-106668

MeSH Terms:
Models, Psychological Humans Psychological Theory
Social Control, Informal Personality Personality Development
Research Design Choice Behavior Internal-External Control
Temperament Freedom Self Efficacy
Personal Autonomy Personality Assessment Ego

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