The research proposed will apply recent advances in biochemical
epidemiology to the development and evaluation of a state-of-the-art lung
cancer prevention program. Specifically, we will test bio-behavioral
interventions which incorporate personalized biomarker feedback about
tobacco exposure (i.e., carbon monoxide (CO) levels) and host
susceptibility to tobacco (i.e., debrisoquine metabolic phenotype) into
a standard minimal contact smoking cessation intervention. Subjects will
be 1,000 male and female smokers recruited through newspaper
advertisements, including those targeted to minorities. Eligible smokers
will complete an initial evaluation to assess baseline levels of the
following variables; smoking history, perceptions of vulnerability,
decisional balance ('pros' and cons" of smoking), stage and processes of
smoking behavior change, coping style, and psychological adaptation.
Subjects will be assigned randomly to one of three study conditions: (1)
standard Quit-Smoking Consultation (QSC); (2) QSC + Exposure Biomarker
feedback (EBF, or (30 QSC+EBF+Susceptibility Biomarker feedback (SBF).
The QSC is a minimal contact intervention which is based on the Free and
Clear Guide developed and evaluated in a large, randomized self-help quit
smoking trial (Orleans et al., 1991). The QSC+EBF also includes a
motivational intervention delivered prior to the QSC - i.e., provision
of standardized feedback of exhaled carbon monoxide levels. The
QSC+EBF+SBF includes an additional motivational intervention delivered
prior to the QSC=EBF - i.e., provision of standardized feedback of
testing for debrisoquine metabolic phenotype which has been associated
with individual susceptibility to lung cancer. Three an 12-month follow-
up assessments will be used to asses short-and long-term changes in
perceived vulnerability, decisional balance, stage and processes of
change, as well as adherence to recommended quitting strategies, quit
rates, and psychological adaptation. Also, we will determine whether
individuals biologic' (metabolic phenotype) and psychologic profiles
(coping style) moderate the impact of the interventions on the above
outcomes. Finally, we will use regressive models to identify key
variables and causal processes associated with progress through stages
of smoking behavior change and cessation.
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- The DCCPS Team.