DESCRIPTION (Applicant's abstract): There are over 13 million smokers ages 50+
in the United States, who tend to be heavy, long-term smokers who are more
likely to have chronic diseases caused or exacerbated by smoking. Stopping
smoking can reduce morbidity and mortality from disabling diseases and
conditions across the lifespan. Thus, the implications of smoking and smoking
cessation for maintenance of health and independent living for older
populations are considerable. Little data are available on effective treatments
for smoking in this growing population. Assisted self-help interventions seem
particularly appropriate to this group, who may be limited geographically or by
health status in their ability to access smoking intervention services.
Preliminary results from the current and preceding trials suggest that
proactive telecounseling, in combination with a self-help manual and access to
a reactive quitline, enhances quit rates, particularly among those using
concurrent pharmacotherapy for smoking cessation. Results of other trials
indicate that multiple quit attempts are often necessary to achieve smoking
abstinence, and telecounseling may enhance recycling (i.e., re-quitting after a
failed attempt). The proposed study will extend the scope of the current trial
to examine the effectiveness of recycling smokers ages 50+ with a failed quit
attempt in the past two years (recruited from the current trial and
supplemented with community recruits). Two groups will be compared: 1) Minimal
Intervention Control - self-help manual and access to a reactive quitline
(smokers call in to the quitline for assistance); and 2) Proactive - manual and
quitline along with proactive telecounseling calls (calls out to participants)
to supporting re-quitting and supporting use of FDA approved pharmacotherapies
for smoking cessation (nicotine replacement, bupropion, and others if they are
approved during the period of study. Subjects will be followed at 6, 12, and 18
months for assessment of smoking status, health outcomes, and use of cessation
resources (manual, quitline, proactive telecounseling, pharmacotherapy)
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- The DCCPS Team.