Trauma-Informed Smoking Cessation for Women

About This Grant

ABSTRACT Cigarette smoking is the leading preventable cause of premature cancer-related mortality in the US. Quitting smoking lowers cancer risk, improves mental health, and can increase life expectancy by 10 years. Women are less successful in their attempts to quit smoking and their rates of quitting are lower than that of men. Women experience greater smoking-related disease and increased risk of mortality from smoking. Women face distinct challenges which can impede smoking cessation. One particularly important factor is psychological trauma. Women have a greater prevalence of trauma exposure and are three times more likely to experience post- traumatic stress disorder compared to men. Trauma is a significant risk factor for smoking initiation and is associated with lower quit rates and increased cancer risk in women. However, no national studies have examined the impact of trauma on difficulty with tobacco cessation in women. Further, though the use of trauma- informed approaches has improved treatment engagement and outcomes for patients with alcohol and other substance use, studies have not evaluated trauma-informed approaches to tobacco cessation in women. The proposed training and research plan for this K08 application will enable Dr. Anita Hargrave to obtain the necessary skills to achieve her career goal of becoming an independent NIH-funded clinician-investigator leveraging expertise in advanced statistical analyses, implementation science, and clinical trials to improve tobacco cessation and women’s cancer prevention using trauma-informed approaches. With a highly experienced mentorship team and a thorough training plan, Dr. Hargrave will build on her prior experience in trauma and cancer-related research to obtain mastery in using nationally representative survey data, applying implementation science behavior change theory, and conducting a pilot randomized controlled trial. This training will complement and facilitate the completion of her research aims: (1) assess challenges to successful tobacco cessation among women with and without trauma histories using a national survey; (2) conduct a formative evaluation using an implementation framework to adapt an evidence-based tobacco cessation intervention by incorporating trauma-informed approaches; (3) determine the feasibility and acceptability of the novel trauma- informed tobacco cessation intervention in a 12-month pilot randomized controlled trial (RCT). The proposed research will inform the development of an R01 application to evaluate the trauma-informed tobacco cessation intervention in a full-scale RCT, with the goal of improving tobacco cessation and cancer prevention for women with histories of trauma.