A guided imagery tobacco cessation intervention delivered by a quitline and website

University Of Arizona, Tucson AZ

Investigators

Linked publications, trials & patents

Abstract

ABSTRACT Cigarette smoking is the leading cause of death accounting for more than 480,000 deaths each year, and 16 million Americans suffer from one or more diseases caused by smoking. Cessation of tobacco use can significantly reduce the risk of disease. Telephone quitlines are an effective and highly scalable way to help individuals quit smoking. However quitlines are an underutilized resource, and do not reach certain segments of the population, including males and racial/ethnic minorities. Guided imagery is a form of mind-body therapy that involves controlled visualization of specific mental images, and shares similarities with mindfulness meditation. Multiple studies have shown that exposure to mindfulness and imagery training results in significantly increased smoking abstinence rates. Also, imagery is used by a significant number of racially diverse male and female athletes. Although imagery is an effective tool for smoking cessation, the mode of delivery has generally been in person, limiting the dissemination to large populations. We hypothesize that guided mental imagery delivered using the uitline ?coaching model? combined with an interactive website could be an effective and disseminable intervention strategy. In addition, this model may be more readily accepted by underrepresented smokers, and may increase the reach and effectiveness of telephone quitlines. Therefore, the objective of this three year R34 application is to develop and test the feasibility of a theory-driven, telephone plus web-based, guided mental imagery intervention for smoking cessation. We will develop the intervention and attention-control condition, study procedures, training protocols, and competency testing models with input from quitline personnel, and focus and user groups of smokers in preparation for a randomized clinical trial. We will conduct a feasibility trial (N=100) to gather preliminary data on recruitment, retention, and preliminary estimates of the potential effects of the guided mental imagery intervention on quitline callers? tobacco use, cravings, and self-efficacy to quit smoking. Participants will be randomly assigned to receive either the Imagery Intervention or a matched control condition delivered by project imagery coaches. Participants will be assessed at baseline, 6-weeks and 6-months post-enrollment. Primary outcomes will be self-reported point prevalence and prolonged abstinence of tobacco use. A subsample of 20 quitters will be tested for salivary cotinine as biochemical validation of self-report in this population. Secondary outcomes will be self-reported cravings and self-efficacy. A manual of procedures will be developed to prepare us to conduct a future randomized controlled trial to determine the efficacy of the imagery intervention. The proposed project has the potential to advance the science of tobacco cessation through the addition of guided mental imagery, and improve public health through increased reach of telephone quitlines. It is innovative in that it uses guided imagery to address theory-driven targets of self-efficacy for abstinence and cravings. If successful, this model could be expanded to address other health behaviors such as diet, physical activity and other substance use.