? DESCRIPTION (provided by applicant): Despite development of relapse prevention interventions ranging in intensity from extended counseling and/or pharmacotherapy to minimal interventions (e.g. mailed booklets), overall long-term success rates of smoking quit attempts remains low. To date, relapse prevention interventions have focused on the newly abstinent smoker (abstainer), and not attempted to directly or indirectly influence the abstainer's personal network, e.g. by helping the abstainer influence others in their personal network to quit. Personal networks (PNs) have powerful effects on initiating and maintaining smoking behavior and they also have great potential to facilitate smoking cessation. A reach out and help others intervention that seeks to increase the abstainer's ability to influence smokers in their PN to qui - thereby creating a social environment more supportive of long-term abstinence - may have a beneficial effect on relapse. Possible mechanisms include: 1) encouraging public commitment to abstinence (within PN); 2) creating cognitive dissonance with resuming smoking; 3) reinforcing/consolidating learning of cessation benefits/effective aids (through teaching others); 4) maintaining engagement with the quit attempt (through helping others quit); 5) providing additional or alternative strategies for coping with smokers in the social environment, and 6) shifting the PN's norms toward smoking abstinence. The Helpers Program (Helpers) is an existing on-line tobacco cessation brief intervention (BI) training program that teaches lay community members how to help tobacco users quit through a non-confrontational helping conversation (BI). The Helpers approach emphasizes active listening and motivational communication skills to encourage quitting - with particular attention given to avoiding confrontation and nagging, reinforcing motivations for quitting, and encouraging use of effective cessation aids (e.g. quit lines, cessation medications). We propose to test the feasibility and acceptability of Helpers as a relapse prevention intervention with these Specific Aims: 1) Modify the Helpers Program website for use as a pilot relapse prevention intervention with new abstainers completing the Arizona Smokers' Helpline (ASH) telephone based tobacco cessation program; 2) Conduct an observational feasibility pilot study with 120 abstainers (30-day abstinent) to examine: a) feasibility of recruiting and retaining participants in the study, b) participant initiation and completion of Helpers training, c) self-reported delivery of BIs to othe tobacco users, and d) the number, timing, and duration of participants' lapses/relapses to smoking; and 3) Conduct a social network analysis (SNA) pilot feasibility study with the same 120 abstainers to examine feasibility and acceptability of SNA methods, and various PN parameters needed to design a full-scale SNA study assessing effects of Helpers on PNs, including: a) recruitment and retention of newly abstinent smokers, b) changes in participants' PNs over course of the study (size, composition, structure, number of current/former smokers), c) presence or absence, effect and spread of smoking cessation related information and behaviors within PNs.

R21CA184361

2015-04-01

2019-03-31