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Multibehavioral changes for disease prevention among smokers

Institution: University of California, San Francisco
Investigator(s): Judith Prochaska, Ph.D., M.P.H.
Award Cycle: 2002 (Cycle 11) Grant #: 11FT-0013 Award: $69,824
Subject Area: Epidemiology
Award Type: Postdoctoral Fellowship Awards
Abstracts

Initial Award Abstract
Cigarette smoking accounts for over 400,000 U.S. deaths each year and is the major single leading cause of cancer. Individuals who smoke are also more likely to eat a high fat diet, drink alcohol, and fail to get enough exercise. With each additional problem behavior, health costs and the risk for disease are multiplied. All together, 50% of premature deaths and chronic disability are preventable through changes in behavior. Yet, the national investment in prevention is estimated at less than 5% of total annual health care costs. The evidence supports the need for heath behavior change interventions.

Most quit smoking programs today focus solely on tobacco use. Programs that target change in more than one behavior at a time have the potential to offer greater health benefits and reduce health care costs. Promoting changes in diet and exercise may also help to prevent weight gain and improve mood following smoking cessation. The study of relationships among health behaviors can help identify those individuals at highest risk and the types of interventions needed.

The overall objectives of the proposed research program are to assess the need for and efficacy of multibehavioral changes--simultaneous changes in more than one behavior at a time--for disease prevention. Smokers are targeted because of their particularly poor behavioral profiles. Three phases of research are proposed: (A) analysis of the prevalence of multiple problem behaviors among current, former, and never smokers in a national surveillance study; (B) a systematic review of quit smoking interventions that targeted at least one additional health behavior; and (C) analysis of three multibehavioral trials, which targeted smoking simultaneously with other health behaviors.

The specific questions to be addressed include: 1) What combined treatments are needed to best address the disease risks of smokers? 2) Do quit smoking interventions that target additional health behaviors facilitate greater change and potentially greater health benefits than interventions that target smoking alone? 3) How do smokers and nonsmokers compare in making changes in multiple health behaviors? Does a focus on additional health behaviors compromise efforts to quit smoking?

The proposed research program will analyze data on over 194,361 U.S. adults and contribute to the development of more effective smoking cessation interventions for disease prevention.
Publications

The transtheoretical model applied to depressed smokers._x000D_
Periodical: Society for Research on Nicotine and Tobacco Newsletter Index Medicus:
Authors: Prochaska JJ, Hall SM, Rosen A, et al ABS
Yr: 2003 Vol: Nbr: Abs: Pg:

Processes of change in Chinese and nonChinese American smokers
Periodical: Annals of Behavioral Medicine Index Medicus:
Authors: Prochaska JJ, Tsoh JY, Hall SM, Rossi JS ABS
Yr: 2003 Vol: Nbr: Abs: S47 Pg:

Promoting physical activity in a smoking cessation intervention for older adults.
Periodical: American College of Sports Medicine Index Medicus:
Authors: Prochaska JJ, Humfleet GL, Munoz R, Reus V, Hall SM ABS
Yr: 2003 Vol: Nbr: Abs: Pg:

A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery.
Periodical: Journal of Consulting and Clinical Psychology Index Medicus:
Authors: Prochaska JJ, Delucchi K, Hall SM ART
Yr: 2004 Vol: Nbr: Abs: Pg:

Depressed smokers and stage of change: Implications for treatment interventions.
Periodical: Drug and Alcohol Dependence Index Medicus:
Authors: Prochaska JJ, Rossi JS, Redding CA, Rosen AB, Tosh JY, Humfleet FL, et al ART
Yr: 2004 Vol: Nbr: Abs: Pg:

Impact of nicotine withdrawal on an audit impatient psychiatry unit.
Periodical: Psychiatric Services Index Medicus:
Authors: Prochaska JJ, Gill P, Hall SM ART
Yr: 2004 Vol: Nbr: Abs: Pg: