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Overview

The program involves the marriage of a conceptually distinct model of relapse prevention with a state-of-the-art delivery system. The content of the relapse prevention program will reflect expert knowledge and the experience of members of the University of Wisconsin's Center for Tobacco Research and Intervention (CTRI), while the innovative delivery system will be designed and implemented by personnel of the University of Wisconsin's Center for Health Systems Research and Analysis (CHSRA).

The Need

Relapse is the central problem facing smoking treatment researchers today. Many efficacious cessation techniques exist, including almost half a dozen pharmacotherapies. Intensive cessation programs routinely produce initial abstinence in more than 70% of smokers trying to quit; unfortunately, relapse claims most of these early successes. Of smokers trying to quit, only 10-30% achieve long-term abstinence. To a great extent, cessation programs work by increasing the number of smokers who initially achieve abstinence, not by preventing relapse. The ultimate goal of the current clinical study is to develop and evaluate a computer-based relapse prevention program that will reduce the morbidity and mortality caused by smoking-related disease.

Details

A group of about 100 smokers (stratified on the basis of gender, Internet-connected computer ownership, and depression) in Milwaukee, Wisconsin were randomly assigned to one of two treatment conditions. They all received the same smoking cessation treatment, but differed as to which relapse prevention program they received. All groups received nicotine gum, group counseling, and a phone call one day prior to their quit date. A follow-up visit occurred four weeks after their quit date. For one group this constituted the only "relapse prevention" treatment they received. The second group was given access to the Comprehensive Health Enhancement Support System (CHESS) relapse prevention program. The design permitted us to determine: (1) whether CHESS significantly benefits users; (2) what are the mechanisms of effective relapse prevention; (3) whether the use or impact of CHESS varies with user characteristics; and (4) how well computer resources are accepted by smokers.

Principal Investigators:
David Gustafson Sr., Ph.D