Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers

Yessenia Castro, Karen Basen-Engquist, Maria E Fernandez, Larkin L Strong, Elizabeth G Eakin, Ken Resnicow, Yisheng Li, David W Wetter, Yessenia Castro, Karen Basen-Engquist, Maria E Fernandez, Larkin L Strong, Elizabeth G Eakin, Ken Resnicow, Yisheng Li, David W Wetter

Abstract

Background: Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U.S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities.

Methods/design: The proposed study will evaluate the efficacy of an evidence-based and theoretically-driven Motivation And Problem Solving (MAPS) intervention, adapted and culturally-tailored for reducing cancer risk related to smoking, poor diet, and physical inactivity among high-risk Mexican-origin smokers who are overweight/obese (n = 400). Participants will be randomly assigned to one of two groups: Health Education (HE) or MAPS (HE + up to 18 MAPS counseling calls over 18 months). Primary outcomes are smoking status, servings of fruits and vegetables, and both self-reported and objectively measured physical activity. Outcome assessments will occur at baseline, 6 months, 12 months, and 18 months.

Discussion: The current study will contribute to a very limited evidence base on multiple risk factor intervention studies on Mexican-origin individuals and has the potential to inform both future research and practice related to reducing cancer risk disparities. An effective program targeting multiple cancer risk behaviors modeled after chronic care programs has the potential to make a large public health impact because of the dearth of evidence-based interventions for Latinos and the extended period of support that is provided in such a program.

Trial registration: National Institutes of Health Clinical Trials Registry # NCT01504919.

Figures

Figure 1
Figure 1
Study flow.

References

    1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. doi: 10.1001/jama.291.10.1238.
    1. Ries L, Eisner M, Kosary C, Hankey B, Miller B, Clegg L, Mariotto A, Feuer E, Edwards B. SEER Cancer Statistics Review, 1975–2001. Bethesda, MD: National Cancer Institute; 2004.
    1. United States Department of Health and Human Services. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Rockville, MD: United States Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1990.
    1. Danaei G, Vender Hoorn S, Lopez AD, Murray CJL, Ezzati M. Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet. 2005;366(9499):1784–1793. doi: 10.1016/S0140-6736(05)67725-2.
    1. Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Nat Cancer Insitute. 1981;66(6):1191–1308.
    1. Donaldson MS. Nutrition and cancer: a review of the evidence for an anti-cancer diet. Nutr J. 2004;3:19. doi: 10.1186/1475-2891-3-19.
    1. Block G, Patterson B, Subar A. Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr Cancer. 1992;18(1):1–29. doi: 10.1080/01635589209514201.
    1. Colditz GA, Cannuscio CC, Frazier AL. Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Cause Control. 1997;8(4):649–667. doi: 10.1023/A:1018458700185.
    1. Friedenreich CM, Thune I, Brinton LA, Albanes D. Epidemiologic issues related to the association between physical activity and breast cancer. Cancer. 1998;83(3 Suppl):600–610.
    1. Shephard RJ, Futcher R. Physical activity and cancer: how may protection be maximized? Crit Rev Oconogen. 1997;8(2–3):219–272.
    1. Basen-Engquist K, Chang M. Obesity and cancer risk: recent review and evidence. Cur Oncol Rep. 2011;13(1):71–76. doi: 10.1007/s11912-010-0139-7.
    1. Emmons KM, Marcus BH, Linnan L, Rossi JS, Abrams DB. Mechanisms in multiple risk factor interventions: smoking, physical activity, and dietary fat intake among manufacturing workers. Working well research group. Prev Med. 1994;23(4):481–489. doi: 10.1006/pmed.1994.1066.
    1. Services USDoHaH. Healthy People 2010. Washington, D.C: Department of Health and Human Services; 2001.
    1. Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J. Clustering of risk behaviors with cigarette consumption: a population-based survey. Prev Med. 2006;42(5):348–353. doi: 10.1016/j.ypmed.2006.01.011.
    1. Marrero JA, Fontana RJ, Fu S, Conjeevaram HS, Su GL, Lok AS. Alcohol, tobacco and obesity are synergistic risk factors for hepatocellular carcinoma. J Hepatol. 2005;42(2):218–224. doi: 10.1016/j.jhep.2004.10.005.
    1. Ramirez R. We the People: Hispanics in the United States. Washington, D.C: United States Census Bureau; 2004.
    1. Group USCSW. United States Cancer Statistics: 2002 Incidence and Mortality. Atlanta: United States Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2005.
    1. Centers for Disease Control and Prevention. Cigarette smoking among adults and trends in smoking cessation - United States, 2008. MMWR. 2009;58(44):1227–1232.
    1. Centers for Disease Control and Prevention. Quitting smoking among adults-United States, 2001–2010. MMWR. 2011;60(44):1513–1519.
    1. Centers for Disease Control and Prevention. Prevalence of fruit and vegetable consumption and physical activity by race/ethnicity-United States, 2005. MMWR. 2007;56(13):301–304.
    1. Kendzor DE, Costello TJ, Li Y, Vidrine JI, Mazas CA, Reitzel LR, Cinciripini PM, Cofta-Woerpel LM, Businelle MS, Wetter DW. Race/ethnicity and multiple cancer risk factors among individuals seeking smoking cessation treatment. Cancer Epidemiol Biomarkers Prev. 2008;17(11):2937–2945. doi: 10.1158/1055-9965.EPI-07-2795.
    1. Fiore M, Bailey W, Cohen S, Dorfman S, Goldstein M, Gritz E. Treating tobacco use and dependence: Clinical practice guidelines. Rockville, MD: United States Department of Health and Human Services, Public Health Service; 2000.
    1. Webb MS, Rodriguez-Esquivel D, Baker EA. Smoking cessation interventions among Hispanics in the United States: A systematic review and mini meta-analysis. Am J Health Promot. 2010;25(2):109–118. doi: 10.4278/ajhp.090123-LIT-25.
    1. Mier N, Ory MG, Medina AA. Anatomy of culturally sensitive interventions promoting nutrition and exercise in hispanics: a critical examination of existing literature. Health Promot Prac. 2010;11(4):541–554. doi: 10.1177/1524839908328991.
    1. Emmons KM, Linnan LA, Shadel WG, Marcus B, Abrams DB. The working healthy project: a worksite health-promotion trial targeting physical activity, diet, and smoking. J Occup Environ Med. 1999;41(7):545–555. doi: 10.1097/00043764-199907000-00003.
    1. Emmons KM, McBride CM, Puleo E, Pollak KI, Clipp E, Kuntz K, Marcus BH, Napolitano M, Onken J, Farraye F, Fletcher R. Project PREVENT: a randomized trial to reduce multiple behavioral risk factors for colon cancer. Cancer Epidem Biomarkers Prev. 2005;14(6):1453–1459. doi: 10.1158/1055-9965.EPI-04-0620.
    1. Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, Greene GW, Rossi SR, Sun X, Fava JL, Laforge R, Rakowski W, Plummer BA. Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med. 2005;41(2):406–416. doi: 10.1016/j.ypmed.2004.09.050.
    1. Mata J, Silva MN, Vieira PN, Carraça EV, Andrade AM, Coutinho SR, Sardinha LB, Teixeira PJ. Motivational “spill-over” during weight control: increased self-determination and exercise intrinsic motivation predict eating self-regulation. Sport Exerc Perform Psychol. 2011;1(S):49–59.
    1. Services USDoHaH. Tobacco use among U.S. racial/ethnic minority groups-African Americans, American Indians and Alaskan natives, Asian Americans and Pacific Islanders and Hispanics: A report of the Surgeon General. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1998.
    1. Wetter DW, Mazas C, Daza P, Nguyen L, Fouladi RT, Li Y, Cofta-Woerpel L. Reaching and treating spanish-speaking smokers through the national cancer Institute's cancer information service. A randomized controlled trial. Cancer. 2007;109(2 Suppl):406–413.
    1. McClure JB, Westbrook E, Curry SJ, Wetter DW. Proactive, motivationally enhanced smoking cessation counseling among women with elevated cervical cancer risk. Nicotine Tob Res. 2005;7(6):881–889. doi: 10.1080/14622200500266080.
    1. Reitzel LR, Vidrine JI, Businelle MS, Kendzor DE, Costello TJ, Li Y, Daza P, Mullen PD, Velasquez MM, Cinciripini PM, Cofta-Woerpel L, Wetter DW. Preventing postpartum smoking relapse among diverse low-income women: a randomized clinical trial. Nicotine Tob Res. 2010;12(4):326–335. doi: 10.1093/ntr/ntq001.
    1. Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007;32(5):419–434. doi: 10.1016/j.amepre.2007.01.004.
    1. Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med. 2012;42(1):81–88. doi: 10.1016/j.amepre.2011.08.025.
    1. Miller W, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviors. New York: The Guilford Press; 1991.
    1. Miller W, Rollnick S. Motivational Interviewing. 2. New York: The Guilford Press; 2002.
    1. Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. Am Psychol. 2004;59(4):224–235.
    1. Marlatt GA, Donovan D. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. 2. New York: The Guilford Press; 2005.
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143–164. doi: 10.1177/1090198104263660.
    1. Miller W, Zweben A, Diclemente C, Rychtarik R. Motivational Enhancement Therapy Manual: A Clinical Research Guide forTherapists Training Individuals with Alcohol Abuse and Dependence. Rockville, MD: United States Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism; 1995.
    1. Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003;71(5):843–861.
    1. Heckman CJ, Egleston BL, Hofmann MT. Efficacy of motivational interviewing for smoking cessation: a systematic review and meta-analysis. Tob Control. 2010;19(5):410–416. doi: 10.1136/tc.2009.033175.
    1. Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Brit J Gen Prac. 2005;55(513):305–312.
    1. Martins RK, McNeil DW. Review of motivational interviewing in promoting health behaviors. Clin Psychol Rev. 2009;29(4):283–293. doi: 10.1016/j.cpr.2009.02.001.
    1. Carroll KM. Relapse prevention as a psychosocial treatment: a review of controlled clinical trials. Exp Clin Psychopharm. 1996;4(1):46–54.
    1. Greaves C, Sheppard K, Abraham C, Hardeman W, Roden M, Evans P, Schwarz P, Group TIS. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Pub Health. 2011;11(1):119. doi: 10.1186/1471-2458-11-119.
    1. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47(9):1102–1114.
    1. Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don't. Annals NY Acad Sci. 1999;896(1):3–15. doi: 10.1111/j.1749-6632.1999.tb08101.x.
    1. Gallo LC, Matthews KA. Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull. 2003;129(1):10–51.
    1. Mirowsky J, Ross C. Education, personal control, lifestyle and health. Res Aging. 1998;20:415–449. doi: 10.1177/0164027598204003.
    1. Ross C, Wu C. The links between education and health. Am Sociol Rev. 1995;60:719–745. doi: 10.2307/2096319.
    1. Sciamanna CN, Hoch JS, Duke GC, Fogle MN, Ford DE. Comparison of five measures of motivation to quit smoking among a sample of hospitalized smokers. J Gen Intern Med. 2000;15(1):16–23. doi: 10.1046/j.1525-1497.2000.11198.x.
    1. Prochaska JO, DiClemente CC. In: Progress in Behavior Modification. Herson M, Eisler R, Miller P, editor. Sycamore, IL: Sycamore Publishing Company; 1992. Stages of change in the modification of problem behaviors.
    1. Silva MN, Markland D, Vieira PN, Coutinho SR, Carraça EV, Palmeira AL, Minderico CS, Matos MG, Sardinha LB, Teixeira PJ. Helping overweight women become more active: need support and motivational regulations for different forms of physical activity. Psychol Sport Exerc. 2010;11(6):591–601. doi: 10.1016/j.psychsport.2010.06.011.
    1. Fortier MS, Wiseman E, Sweet SN, O’Sullivan TL, Blanchard CM, Sigal RJ, Hogg W. A moderated mediation of motivation on physical activity in the context of the physical activity counseling randomized control trial. Psychol Sport Exercise. 2011;12(2):71–78. doi: 10.1016/j.psychsport.2010.08.001.
    1. Hughes JR, Keely JP, Fagerstrom KO, Callas PW. Intentions to quit smoking change over short periods of time. Addict Behav. 2005;30(4):653–662. doi: 10.1016/j.addbeh.2004.08.011.
    1. Larabie LC. To what extent do smokers plan quit attempts? Tob Control. 2005;14(6):425–428. doi: 10.1136/tc.2005.013615.
    1. West R, Sohal T. “Catastrophic” pathways to smoking cessation: findings from national survey. BMJ. 2006;332(7539):458–460. doi: 10.1136/.
    1. Bandura A. Toward a psychology of human agency. Perspect Psychol Sci. 2006;1(2):164–180. doi: 10.1111/j.1745-6916.2006.00011.x.
    1. Mirowsky J, Ross C. Estimating defense and agreement bias from measures of the sense of control: A 2x2 index. Soc Psychol Q. 1991;54:127–141. doi: 10.2307/2786931.
    1. DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991;59(2):295–304.
    1. Cinciripini PM, Wetter DW, Fouladi RT, Blalock JA, Carter BL, Cinciripini LG, Baile WF. The effects of depressed mood on smoking cessation: mediation by postcessation self-efficacy. J Consult Clin Psychol. 2003;71(2):292–301.
    1. Shiffman S, Balabanis MH, Paty JA, Engberg J, Gwaltney CJ, Liu KS, Gnys M, Hickcox M, Paton SM. Dynamic effects of self-efficacy on smoking lapse and relapse. Health Psychol. 2000;19(4):315–323.
    1. Koring M, Richert J, Parschau L, Ernsting A, Lippke S, Schwarzer R. A combined planning and self-efficacy intervention to promote physical activity: A multiple mediation analysis. Psychol Health Med. 2012;17(4):488–498. doi: 10.1080/13548506.2011.608809.
    1. Richert J, Reuter T, Wiedemann AU, Lippke S, Ziegelmann J, Schwarzer R. Differential effects of planning and self-efficacy on fruit and vegetable consumption. Appetite. 2010;54(3):611–614. doi: 10.1016/j.appet.2010.03.006.
    1. Kreausukon P, Gellert P, Lippke S, Schwarzer R. Planning and self-efficacy can increase fruit and vegetable consumption: a randomized controlled trial. J Behav Med. 2012;35(4):443–451. doi: 10.1007/s10865-011-9373-1.
    1. Davis J, Glaros A. Relapse prevention and smoking cessation. Addict Behav. 1986;11:15–114.
    1. Hall SM, Rugg D, Tunstall C, Jones RT. Preventing relapse to cigarette smoking by behavioral skill training. J Consult Clin Psychol. 1984;52(3):372–382.
    1. Carels RA, Douglass OM, Cacciapaglia HM, O'Brien WH. An ecological momentary assessment of relapse crises in dieting. J Consult Clin Psychol. 2004;72(2):341–348.
    1. Burgess ES, Brown RA, Kahler CW, Niaura R, Abrams DB, Goldstein MG, Miller IW. Patterns of change in depressive symptoms during smoking cessation: who's at risk for relapse? J Consult Clin Psychol. 2002;70(2):356–361.
    1. Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tipp JE, Johnson J. Smoking, smoking cessation, and major depression. JAMA. 1990;264(12):1546–1549. doi: 10.1001/jama.1990.03450120058029.
    1. Carroll KM, Nuro K. The Technology Model: An introduction to psychotherapy research in substance abuse. New Haven, CT: Yale University Psychotherapy Development Center, Substance Abuse Center; 1996.
    1. Thomas S, Reading J, Shephard RJ. Revision of the physical activity readiness questionnaire (PAR-Q) Can J Sport Sci. 1992;17(4):338–345.
    1. National Heart L, and Blood Institute. 7th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, MD: United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute; 2003.
    1. Lee SY, Bender DE, Ruiz RE, Cho YI. Development of an easy-to-use spanish health literacy test. Health Serv Res. 2006;41(4 Pt 1):1392–1412.
    1. Wilkinson AV, Spitz MR, Strom SS, Prokhorov AV, Barcenas CH, Cao Y, Saunders KC, Bondy ML. Effects of nativity, age at migration, and acculturation on smoking among adult Houston residents of Mexican descent. Am J Pub Health. 2005;95(6):1043–1049. doi: 10.2105/AJPH.2004.055319.
    1. Pocock S. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31(1):103–115. doi: 10.2307/2529712.
    1. Pocock S. Clinician Trials: A Practical Approach. New York: John Wiley and Sons; 1993.
    1. Centers for Disease Control and Prevention. Telephone Quitlines: A Resource for Development, Implementation and Evaluation. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health; 2004.
    1. Moyers T, Martin T, Manuel J, Miller W. The Motivational Interviewing Treatment Integrity (MITI) Code, Version 2.0. Albuquerque, NM: University of New Mexico, Center on Alcoholism, Substance Abuse and the Addictions;
    1. Thompson FE, Midthune D, Subar AF, Kahle LL, Schatzkin A, Kipnis V. Performance of a short tool to assess dietary intakes of fruits and vegetables, percentage energy from fat and fibre. Pub Health Nutri. 2004;7(8):1097–1105.
    1. Wardle J, Parmenter K, Waller J. Nutrition knowledge and food intake. Appetite. 2000;34(3):269–275. doi: 10.1006/appe.1999.0311.
    1. Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003;5(1):13–25.
    1. Velicer WF, Prochaska JO, Rossi JS, Snow MG. Assessing outcome in smoking cessation studies. Psychol Bull. 1992;111(1):23–41.
    1. Hagler AS, Norman GJ, Radick LR, Calfas KJ, Sallis JF. Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent fruit and vegetable and dietary fat intake. J Am Diet Assoc. 2005;105(11):1758–1764. doi: 10.1016/j.jada.2005.08.010.
    1. Heppner WL, Ji L, Reitzel LR, Castro Y, Correa-Fernandez V, Vidrine JI, Li Y, Dolan-Mullen P, Velasquez MM, Cinciripini PM, Cofta-Woerpel L, Greisinger A, Wetter D. The role of prepartum motivation in the maintenance of postpartum smoking abstinence. Health Psychol. 2011;30(6):736–745.
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–1070.
    1. Velicer WF, Diclemente CC, Rossi JS, Prochaska JO. Relapse situations and self-efficacy: an integrative model. Relapse situations and self-efficacy: an integrative model. 1990;15(3):271–283.
    1. Marcus BH, Selby VC, Niaura RS, Rossi JS, Lavallee D, Williams JM, Jones MV. In: Key Studies in Sport and Exercise Psychology. Lavallee D, Williams JM, Jones MV, editor. Maidenhead, BRK England: Open University Press; 2008. Self-efficacy and the stages of exercise behavior change; pp. 93–109.
    1. Smith SS, Piper ME, Bolt DM, Fiore MC, Wetter DW, Cinciripini PM, Baker TB. Development of the brief wisconsin inventory of smoking dependence motives. Nicotine Tob Res. 2010;12(5):489–499. doi: 10.1093/ntr/ntq032.
    1. Palmer KJ, Buckley MM, Faulds D. Transdermal nicotine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy as an aid to smoking cessation. Drugs. 1992;44(3):498–529. doi: 10.2165/00003495-199244030-00011.
    1. MCCulloch C, Searle S. Generalized, Linear, and Mixed Models. New York: John Wiley & Sons, Inc; 2001.
    1. Verbeke G, Molenberghs G. Linear Mixed Models for Longitudinal Data. New York: John Wiley & Sons, Inc; 2000.
    1. Westfall P, Young S. Resampling-based Multiple Testing: Examples and Methods for P-value Adjustment. New York: John Wiley & Sons, Inc; 1993.
    1. MacKinnon DP, Lockwood CM, Brown CH, Wang W, Hoffman JM. The intermediate endpoint effect in logistic and probit regression. Clin Trials. 2007;4(5):499–513. doi: 10.1177/1740774507083434.
    1. Little R, Rubin D. Statistical Analysis with Missing Data. 2. New York: John Wiley & Sons, Inc; 2002.
    1. Diggle R, Kenward M. Informative drop-out in longitudinal data analysis. Appl Stat. 1994;43(1):49–93. doi: 10.2307/2986113.
    1. Wu M, Bailey K. Estimation and comparison of changes in the presence of informative right censoring: conditional linear model. Biometrics. 1989;45:939–955. doi: 10.2307/2531694.
    1. Eldridge S, Kerry S. A Practical Guide to Cluster Randomised Trials in Health Services Research. Chichester, West Sussex, UK: John Wiley & Sons, Ltd; 2012.
    1. Wetter DW, Carmack CL, Anderson CB, Moore CA, De Moor CA, Cinciripini PM, Hirshkowitz M. Tobacco withdrawal signs and symptoms among women with and without a history of depression. Exp Clin Psychopharm. 2000;8(1):88–96.
    1. Wetter DW, Fiore MC, Baker TB, Young TB. Tobacco withdrawal and nicotine replacement influence objective measures of sleep. J Consult Clin Psychol. 1995;63(4):658–667.
    1. Wetter DW, Fiore MC, Young TB, McClure JB, de Moor CA, Baker TB. Gender differences in response to nicotine replacement therapy: objective and subjective indexes of tobacco withdrawal. Exp Clin Psychopharm. 1999;7(2):135–144.
    1. Wetter DW, Kenford SL, Smith SS, Fiore MC, Jorenby DE, Baker TB. Gender differences in smoking cessation. J Consult Clin Psychol. 1999;67(4):555–562.
    1. Cohen S. Statistical Power Analysis for the Behavioral Sciences. Hhillsdale, NJ: Lawrence Earlbaum Associates, Inc; 1988.
    1. Prevention CfDCa. Cigarette smoking among adults-United States, 2000. MMWR. 2002;51(29):642–645.
    1. Hunt MK, Stoddard AM, Barbeau E, Goldman R, Wallace L, Gutheil C, Sorensen G. Cancer prevention for working class, multiethnic populations through small businesses: the healthy directions study. Cancer Cause Control. 2003;14(8):749–760. doi: 10.1023/A:1026327525701.
    1. Glasgow RE, Terborg JR, Hollis JF, Severson HH, Boles SM. Take heart: results from the initial phase of a work-site wellness program. Am J Pub Health. 1995;85(2):209–216. doi: 10.2105/AJPH.85.2.209.
    1. Glasgow RE, Terborg JR, Strycker LA, Boles SM, Hollis JF. Take heart II: replication of a worksite health promotion trial. J Behav Med. 1997;20(2):143–161. doi: 10.1023/A:1025578627362.
    1. Emmons KM, Stoddard AM, Gutheil C, Suarez EG, Lobb R, Fletcher R. Cancer prevention for working class, multi-ethnic populations through health centers: the healthy directions study. Cancer Causes Control. 2003;14(8):727–737. doi: 10.1023/A:1026375408862.
    1. Glasgow RE, Orleans CT, Wagner EH. Does the chronic care model serve also as a template for improving prevention? Milbank Q. 2001;79(4):579–612. doi: 10.1111/1468-0009.00222. iv-v.
    1. Steinberg MB, Schmelzer AC, Richardson DL, Foulds J. The case for treating tobacco dependence as a chronic disease. Ann Intern Med. 2008;148(7):554–556.
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;288(15):1909–1914. doi: 10.1001/jama.288.15.1909.
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288(14):1775–1779. doi: 10.1001/jama.288.14.1775.

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