DESCRIPTION (provided by applicant): Adolescence may represent a uniquely challenging but important life period for smoking-cessation efforts. Many of the challenges in working with adolescent smokers are compounded for adolescents living in rural Appalachian regions of the country. Consistent with this notion are findings that smoking rates for adults and adolescents are considerably higher in Appalachia than national averages. Also, adolescents in Appalachia appear to start smoking at younger ages, which has been associated with greater difficulties quitting smoking later in life. In response to the need for treatments appropriate for adolescent smokers in rural Appalachia, this research (utilizing a two-group randomized-control design, n = 35 per group) will evaluate the effectiveness and efficacy of a new and innovative Web-based contingency management (CM) program for smoking abstinence with adolescent smokers living in Appalachian Ohio. Because this CM program is Web-based it can be completed from home, which stands to be more viable as a treatment option for rural adolescent smokers than other treatments requiring frequent trips to a clinical facility. From preliminary work with adult and adolescent smokers, it is expected this program will be highly effective in promoting smoking abstinence among adolescent smokers in Appalachian Ohio. This research also will involve six weekly post-treatment follow-up sessions to determine consistencies or changes in smoking behavior following treatment. A secondary goal of this research is to explore pre-treatment assessments of different dimensions of impulsive behavior as predictors of treatment outcome. We will complete this aspect of the research using a Mobile Behavioral Research Lab. These behavioral assessments will provide highly detailed information about the specific behavioral styles of adolescent smokers who are unable to effectively change their smoking behavior during treatment. This information should provide new points of emphasis for program modifications to improve these programs to be more effective for Appalachian adolescents most challenged in their efforts to quit or reduce smoking. Cigarette smoking is the top preventable cause of death in the United States, and rates of smoking for adults and adolescents are consistently higher in Appalachian regions than national averages. This study will evaluate a novel behavioral treatment for cigarette smoking cessation with Appalachian adolescent smokers. Further, this study will advance our understanding of the different behavioral styles associated with these adolescents' ability to quit or reduce smoking during a treatment program for smoking cessation. This latter aim is expected to guide smoking treatment modifications to make these treatments more effective for adolescents who are trying to quit or reduce smoking.
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