More than 21% of men and 17% of women in the US are current smokers. Get more facts.
Reducing tobacco use prevalence will require advances in both the basic and applied science of implementation and dissemination. Perhaps the most pressing challenge to the field is to understand how to move basic and clinical research out of the laboratory and into the real world more effectively and efficiently to inform a coherent, unified national cessation strategy. An important challenge for implementation research is to reach and intervene on populations that are not motivated to quit and/or who have a disproportionately high tobacco use prevalence and disease burden, such as those of low socioeconomic status and underserved racial and ethnic minorities. Research at the Schroeder Institute focuses on increasing the awareness, motivation and demand for cessation treatments among smokers and developing and evaluating a range of flexible and efficient cessation treatment interventions.
Web and Internet-Based Interventions
Web and Internet interventions for smoking cessation – particularly those that leverage online social networks – have enormous potential to reach millions of smokers who might not otherwise access cessation treatment. Implementation research using online networks is a major focus of our work.
Improving Adherence to Web-Based Cessation Programs: A Social Network Approach is a National Cancer Institute-funded (R01 CA155489-01A1) randomized trial that tests the effectiveness of a social network intervention in improving adherence to the evidence-based behavioral, pharmacologic and social support components of web-based cessation treatment.
Online Social Networks for Dissemination of Smoking Cessation Interventions is an NCI-funded (R01 CA155369-01A1) project to study the dissemination of an evidence-based intervention through the massive Facebook social network with the goal of determining intervention characteristics that drive viral spread.
Screenshots of the Schroeder Institute’s Facebook app "UbiQUITous"
|Click the button above to access the app on Facebook.|
mHealth: Cessation Interventions Via Mobile Devices
The pervasiveness and social acceptance of mobile devices has enabled a new field of behavioral research with significant implications for smoking cessation. A growing body of evidence demonstrates the effectiveness of text-message based interventions for smoking cessation, globally and in the United States. As such, the Schroeder Institute Special Projects Team is building the Ginzu system, a dynamic, interactive, personalized text messaging platform that is supported by email and voice components and can be used by multiple concurrent organizations and partners. Ginzu implementation may include integration with hospital-based electronic health records, quitlines, websites and Facebook apps.
Mobile devices are often used to observe and assess behavioral phenomena by asking participants to enter discrete data elements that are transmitted in real time. The Schroeder Institute is also leading a number of efforts to move from this kind of "ecological momentary assessment" approach to one that enables "momentary interventions." Funded by the National Institute on Drug Abuse, Comparative Effectiveness of Web-based Mobile Support for the DC Tobacco Quitline (RC1 DA028710-01) is an example of this kind of research in which web-enabled mobile devices are used to directly supplement and enhance the efficiency, fidelity and impact of an established community-based tobacco quitline program that targets underserved communities in Washington, DC.
Tobacco Use and HIV/AIDS
Tobacco use is alarmingly high among individuals with HIV/AIDS and leads to increased risk of multiple complications including emphysema, cardiac disease and malignancy. In the age of effective anti-retroviral medications, effective cessation interventions have the potential both to dramatically improve quality of life and decrease overall mortality. Funded by the National Institute on Drug Abuse (5 RO1 DA018079), Ethnic Health - Motivating HIV+ Latinos to Quit Smoking is a randomized controlled trial to develop and evaluate a clinic-based, culturally tailored smoking cessation treatment for a largely low-income, Latino, HIV+ population.
Consumer Demand Research
The Consumer Demand initiative—formally titled Innovations in Building Consumer Demand for Tobacco Cessation Products and Services—began as a series of roundtable meetings and culminated in a national conference. The initiative had three goals:
1) To generate new ways of thinking about increasing demand for evidence-based tobacco cessation products and services; 2) to achieve major breakthroughs in the use of tobacco cessation products and services to increase the public health or population impact; and 3) to identify and catalyze feasible innovations in R&D, product design, research funding, practice and policy that could significantly improve the use and impact of current evidence-based treatments within the next three years.
Schroeder Institute investigators played key roles in the Consumer Demand initiative and several related projects. Some of this ongoing work culminated in a special supplement to the American Journal of Preventive Medicine in March 2010 where Schroeder Institute investigators led five of the papers published. Three of these papers were based on an integrative systems framework and simulation modeling of combined effects of multilevel contexts. The recent report from United States Health and Human Services Secretary Kathleen Sebelius, “DHHS Tobacco Control Strategic Plan for the Nation” (Nov 14th, 2010), cited one of these papers as “the most current and authoritative model of the effect of comprehensive tobacco control measures.” Examples of papers from this supplement include:
- Orleans CT, Mabry PL, Abrams DB. Increasing Tobacco Cessation in America: A Consumer Demand Perspective. Am J Prev Med. 2010 Mar;38(3 Suppl):S303-S306. PMID: 20176300. No abstract available.
- Abrams DB, Graham AL, Levy DT, Mabry PL, Orleans CT. Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy. Am J Prev Med. 2010 Mar;38(3 Suppl):S351-63. PMID: 20176308.Abstract.
- Levy DT, Graham AL, Mabry PL, Abrams DB, Orleans CT. Modeling the impact of smoking-cessation treatment policies on quit rates. Am J Prev Med. 2010 Mar;38(3 Suppl):S364-S372. PMID: 20176309. Full text.
- Levy DT, Mabry PL, Graham AL, Orleans CT, Abrams DB. Reaching Healthy People 2010 by 2013: A SimSmoke simulation. Am J Prev Med. 2010 Mar;38(3 Suppl):S373-81. PMID: 20176310. Full text.