Abstinence Reinforcement Therapy (ART) for rural veterans: Methodology for an mHealth smoking cessation intervention^

摘要

Cigarette smoking is the most lethal substance use disorder in the United States in terms of morbidity and mortality [1], and it disproportionately affects U.S. veterans [2,3] and individuals living in rural areas [4]. Compared to urban- and suburban-residing adults, rural adults have significantly higher rates of smoking, with nearly one quarter of rural adults endorsing current smoking [5]. Specifically, urban/rural differences in cigarette use are most pronounced in the South Atlantic region of the U.S. [6]. In the context of heightened smoking risk, rural veterans are also less likely to access healthcare services through the VHA or private sectors [7,8]. Additionally, rural veterans are less likely to receive advice to quit from VHA providers, and are also less likely to receive important information about smoking cessation treatments [9]. Given the prevalence of smoking in rural veterans and their reduced access to VHA smoking cessation treatment, there is a need to develop smoking cessation interventions that are cost-effective and increase the reach of intensive smoking cessation services for rural veterans.