ACUTE NICOTINE ABSTINENCE IN ADOLESCENTS

申请人将进行详细的，前瞻性的审查， 男性和女性青少年的烟草戒断症状， 烟草制品的重度使用者、轻度使用者或非使用者 （包括香烟和无烟烟草）。 成年人，身体 通过戒断症状的存在来证明依赖性， 已知是维持吸烟的重要因素， 尼古丁戒断的强度已经被证明是直接 与尼古丁使用的强度相关。 有人建议 与成年人一样，青少年也可能对尼古丁产生身体依赖。 然而，所有研究尼古丁戒断的发生率， 青少年在本质上是回顾性的，但他们认为， 青少年的自我报告表明，他们也经历了 戒断尼古丁期间的戒断。 具体目标是 建议（1）进行前瞻性和系统性研究， 不同剂量的青少年尼古丁戒断症状 烟草使用（重度使用者、轻度使用者、非使用者） 尼古丁戒断措施以及临床研究所 麻醉评估（CINA）量表-（2）评估 青少年尼古丁戒断的发生率，（3）确定 如果青少年在使用尼古丁期间出现认知能力缺陷， 如果这些赤字在重度使用者中更大， 烟草制品的轻度使用者，（4）评估 尼古丁摄入期间对身体和精神压力的反应 戒烟，在大量和少量使用烟草制品，相比之下， 非烟草使用者和（5）记录 下丘脑-垂体-肾上腺（HPA）轴和交感神经系统 在尼古丁戒断和暴露于压力下。 这项研究的结果将有重大影响， 使用尼古丁替代品和其他治疗青少年 药物管理戒断，也可以帮助阐明 认知缺陷和压力在维持吸烟中作用 青少年吸烟确定身体依赖性和相关 青少年烟草使用者的变化也可能提供宝贵的 关于开发和维护过程的信息 尼古丁依赖

The applicants will conduct a detailed, prospective examination of tobacco withdrawal symptoms of male and female adolescents who are either heavy users, light users or nonusers of tobacco products (including cigarettes and smokeless tobacco). In adults, physical dependence as documented by the presence of withdrawal symptoms, is known to be an important factor in the maintenance of cigarette smoking, and the intensity of nicotine withdrawal has been shown to be directly correlated to the intensity of nicotine use. It has been suggested that like adults, adolescents may also be physically dependent on nicotine. However, all the studies examining incidence of nicotine withdrawal in adolescents have been retrospective in nature, but they suggest that self-reports from adolescents indicate that they also experience withdrawal during abstinence from nicotine. The specific aims of this proposal are (1) to conduct a prospective and systematic study of nicotine withdrawal symptomatology in adolescents who differ in amount of tobacco use (heavy users, light users, nonusers) using standard nicotine withdrawal measures as well as the Clinical Institute for Narcotic Assessment (CINA) scale-(2) to evaluate gender differences in the incidence of nicotine withdrawal in adolescents, (3) to determine if adolescents experience cognitive performance deficits during nicotine withdrawal and if these deficits are greater in heavy users compared with light users of tobacco products, (4) to evaluate alterations in responsivity to both physical and mental stress during nicotine withdrawal, in heavy and light users of tobacco products, compared with nonusers of tobacco and (5) to document alterations in responsivity of the hypothalamo-pituitary-adrenal (HPA) axis and sympathetic system during nicotine withdrawal and exposure to stress. The results of this study would have substantial implications for the use of nicotine substitution and other treatments in adolescents for the pharmacological management of withdrawal, and could also help elucidate the role of cognitive deficits and stress in maintaining cigarette smoking in adolescents. Determining physical dependence and related changes in adolescent tobacco users may also provide valuable information regarding the process of development and maintenance of nicotine dependence.