||5R01CA074517-05 Interpret this number
||Group Health Cooperative
||Individualized Relapse Prevention Among Women Smokers
Among women, the epidemic of smoking related cancers continues to
grow and lung cancer recently surpassed breast cancer as the leading
cause of cancer mortality. Smoking cessation is a cornerstone of
cancer prevention and control because cancer risk declines following
smoking cessation. Unfortunately, relapse is the "rule rather than
the exception" among smokers attempting to quit and relapse remains
the most refractory aspect of nicotine dependence. Women appear to
have higher relapse rates than men and relapse prevention has been
identified as a priority in reducing smoking prevalence among women.
Basic and clinical research on the precipitants of smoking relapse
have demonstrated that coping behaviors are powerful determinants
of relapse. The most influential model of smoking relapse, "relapse
prevention" (Marlatt & Gordon, 1985), proposes that self-efficacy
and outcome expectations are causal determinants of coping
behaviors, and in fact, these variables have been among the better
predictors of relapse. Moreover, there is evidence that
interventions based on relapse prevention theory are effective, that
they instill coping skills, and that coping skill acquisition
mediates intervention effects on abstinence.
The specific aims of this proposal are to: l) Develop and evaluate
the efficacy of a unique, self-help smoking relapse revention
intervention among women. The intervention will be administered via
a small hand-held computer. The general ontent of the intervention
will be tailored specifically for women and each participant's
intervention will be individualized prior to delivery based on
state-of-the-art "ecological momentary assessment" techniques; and,
2) Examine the effects of the relapse prevention intervention on
hypothesized treatment mechanisms (coping behaviors, self-efficacy,
processes of change, negative affect, perceived stress) and the
impact of those mechanisms on relapse, i.e. test for mediation
The proposal translates basic and clinical behavioral science
research into a novel, theoretically-based treatment that provides
individualized, situation-specific coping strategies, motivational
and supportive messages, and other relapse prevention information.
Moreover, unlike conventional relapse prevention treatments,
participants have access to the intervention at an time and in any
place, i.e. the intervention occurs in real-time in naturally
occurring settings. The intervention has the potential to produce
significant advances in the prevention of smoking relapse.
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