Webb Hooper Monica, Lee David J, Simmons Vani N, Brandon Karen O, Antoni Michael H, Unrod Marina, Asfar Taghrid, Correa John B, Koru-Sengul Tulay, Brandon Thomas H
Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, 10900 Euclid Ave, Cleveland, OH 44106, United States.
Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, United States.
Contemp Clin Trials. 2018 May;68:127-132. doi: 10.1016/j.cct.2018.03.017. Epub 2018 Apr 1.
Racial/ethnic disparities in tobacco cessation are such that U.S. minorities have greater difficulty quitting compared to White non-Hispanics. Group differences in distress (i.e., perceived stress and depressive symptoms) may contribute to cessation disparities. The allostasis model of health suggests that the toll of chronic stress experienced by racial/ethnic minorities may lead to dysregulation of the physiological stress system and drug use. Previous research suggests that group cognitive behavioral therapy (CBT) for tobacco cessation addresses distress as a modifiable mechanism and has the potential to reduce/eliminate disparities. The present study is a dualsite randomized controlled trial aimed at evaluating the efficacy of group CBT in eliminating racial/ethnic differences in smoking cessation and distress. The study utilizes a [2 (intervention: group CBT or group general health education [GHE]) × 3 (race/ethnicity: African American/Black, Hispanic, White)] factorial design by randomizing 225 adult smokers from the community. Both interventions provide eight counseling sessions and eight weeks of nicotine patch therapy. Assessments occur at the end-of-therapy, and at 3-, 6-, and 12-months. Generalized longitudinal mixed modeling will be used to test our primary abstinence outcome, biochemically-confirmed 7-day point prevalence abstinence at 12-months. We hypothesize that group CBT will reduce or eliminate racial/ethnic differences in perceived stress, depressive symptoms, and smoking cessation compared to group GHE. We also hypothesize that reductions in physiological distress, assessed by salivary cortisol, will mediate racial/ethnic group differences in smoking cessation, particularly among racial/ethnic minorities. This study has implications for eliminating disparities in psychosocial factors related to tobacco use and cessation.
Clinicaltrials.govNCT02511236. Registered on July 27, 2015.
烟草戒烟方面的种族/族裔差异使得美国少数族裔相比非西班牙裔白人更难戒烟。痛苦（即感知到的压力和抑郁症状）方面的群体差异可能导致戒烟差异。健康的稳态负荷模型表明，种族/族裔少数群体经历的慢性压力负担可能导致生理压力系统失调和药物使用。先前的研究表明，用于戒烟的团体认知行为疗法（CBT）将痛苦作为一种可改变的机制来处理，并且有可能减少/消除差异。本研究是一项双地点随机对照试验，旨在评估团体CBT在消除戒烟和痛苦方面的种族/族裔差异方面的疗效。该研究采用[2（干预：团体CBT或团体一般健康教育[GHE]）×3（种族/族裔：非裔美国人/黑人、西班牙裔、白人）]析因设计，将225名社区成年吸烟者随机分组。两种干预措施均提供八次咨询会议和八周的尼古丁贴片治疗。评估在治疗结束时以及3个月、6个月和12个月时进行。广义纵向混合模型将用于检验我们的主要戒断结果，即12个月时经生化确认的7天点患病率戒断。我们假设，与团体GHE相比，团体CBT将减少或消除在感知压力、抑郁症状和戒烟方面的种族/族裔差异。我们还假设，通过唾液皮质醇评估的生理痛苦的减少将介导戒烟方面的种族/族裔群体差异，特别是在种族/族裔少数群体中。本研究对于消除与烟草使用和戒烟相关的社会心理因素方面的差异具有重要意义。
Clinicaltrials.govNCT02511236。于2015年7月27日注册。
