A controlled evaluation of abstinence-induced withdrawal and motivation to vape/smoke among daily ENDS users vs. cigarette smokers

项目概要/摘要 戒断是烟草/尼古丁依赖的一个关键、多方面的组成部分。因为戒断 症状被理论化为促使复发，戒断的方面（例如，渴望，负面影响）是 大多数当前和新兴治疗方法的目标。尽管撤军至关重要， 大量关于戒烟的文献，我们对吸烟知之甚少。 电子尼古丁输送系统（ENDS）。克服关键障碍， 在该领域的进展，我们提出了有史以来第一个前瞻性的，控制比较禁欲- 在ENDS vapers和吸烟者之间诱导戒断。参与者将有160人 每日电子烟使用者（包括前吸烟者和偶尔吸烟的双重使用者），160人 每日吸烟者（包括前vapers和偶尔使用vape的双重用户），以及（对于探索性的 比较）50个建立的每日双重用户，每天吸烟和vape。参与者将完成 两次4小时的实验室访视;随意使用访视和禁欲访视的顺序（24小时后） 禁欲）将在参与者中随机分配。为了提高对ENDS退出的认识，我们 将采用最先进的科学，多措施，多方法评估的关键退出方面： 负面情绪，渴望，难以集中注意力，坐立不安，睡眠和食欲，以及 快感缺乏/积极情感和躯体效应。我们假设，对于每个方面， 与吸烟者相比，电子烟使用者的数量将较低。为理论和干预提供信息 开发，我们还将评估ENDS退出的行为意义，测试 假设禁欲将增加vape/吸烟的动机，而这种群体差异将 由电子烟使用者/吸烟者在一个或多个戒断方面的差异来解释（介导）。 探索性分析将检查是否考虑了退出的组间差异 通过差异尼古丁暴露（介导），探索个体差异的作用（例如，性别， 尼古丁代谢，预期），并检查vapers亚组之间的差异。的影响 这种急需的，详细的特征退出ENDS是加强了包括 吸烟对公共健康有着重要的意义。此外，通过表征 驱动动机vape/吸烟的具体退出方面，拟议的工作将确定 为后续治疗开发工作提供有前景的干预目标。

PROJECT SUMMARY/ABSTRACT Withdrawal is a key, multi-faceted component of tobacco/nicotine dependence. Because withdrawal symptoms are theorized to drive relapse, facets of withdrawal (e.g., craving, negative affect) are the targets of most current and emerging treatments. Despite the central importance of withdrawal, and a voluminous literature on withdrawal from combustible cigarette smoking, we know little about withdrawal from electronic nicotine delivery systems (ENDS). To overcome critical barriers to progress in the field, we propose the first-ever prospective, controlled comparison of abstinence- induced withdrawal between ENDS vapers and cigarette smokers. Participants will be 160 established daily vapers (including former smokers and dual users who smoke occasionally), 160 established daily smokers (including former vapers and dual users who vape occasionally), and (for exploratory comparisons) 50 established daily dual users, who smoke and vape daily. Participants will complete two 4-hour lab visits; the order of the ad lib use visit and the abstinent visit (which follows 24 hours of abstinence) will be randomized across participants. To advance knowledge of ENDS withdrawal, we will employ state-of-the-science, multi-measure, multi-method assessments of key withdrawal facets: negative affect, craving, difficulty concentrating, restlessness, sleep, and appetite, as well as anhedonia/positive affect and somatic effects. We hypothesize that, for each facet, withdrawal magnitude will be lower among vapers compared to smokers. To inform theory and intervention development, we will also evaluate the behavioral significance of ENDS withdrawal, testing the hypotheses that abstinence will increase the motivation to vape/smoke and this group difference will be accounted for (mediated) by vaper/smoker differences in one or more withdrawal facets. Exploratory analyses will examine whether group differences in withdrawal are accounted for (mediate) by differential nicotine exposure, explore the role of individual differences (e.g., sex, rate of nicotine metabolism, expectancies), and examine differences among sub-groups of vapers. The impact of this much-needed, detailed characterization of withdrawal from ENDS is enhanced by the inclusion of a comparator of great public health significance, cigarette smoking. In addition, by characterizing the specific withdrawal facets that drive motivation to vape/smoke, the proposed work will identify promising intervention targets for subsequent treatment development efforts.