Experimental Analysis of Smoking Relapse

复发仍然是任何戒烟尝试的最可能的结果，多达80- 90%的试图戒烟的人最终又吸烟了。更好的预防复吸的方法可以显著降低吸烟相关的发病率和死亡率，包括癌症相关的死亡率。复发的最有力的预测因素之一是戒烟后的一次吸烟发作。然而，很少有研究旨在阐明这种失效-复发关联的潜在机制，或者确实确定是否存在因果关系。为了更全面地了解失效与复发之间的关系，有必要进行系统的研究。在这方面极为有用的是一个短期的戒烟和复吸模式，它将允许在相对较短的时间内控制吸烟的消失和跟踪结果。这种模型将大大提高数据收集的效率，而不是冗长而昂贵的临床试验设计。本项目建议在我们实验室之前进行的一项研究的基础上进行后续研究，该研究利用戒烟和复吸的短期模型来调查早期戒烟期间程序性失禁的影响（Chornock et al., 1992）。具体来说，我们建议a)在模拟戒烟模型中检查戒烟和复吸结果，该模型使用金钱激励来减缓复吸过程；b)检查模拟戒烟模型中的实验失效效应；c)通过比较暴露于含尼古丁和不含尼古丁香烟的效果，确定尼古丁暴露在吸烟失效效应中的作用。总的来说，该项目将提高我们对吸烟复发和影响这一过程的变量的理解。特别是，将开发新的短期戒烟和复吸模式。此外，使用这些新模型，将获得有关在短暂的戒烟（失效）后吸烟的潜在强大影响的有价值的信息。

Relapse continues to be the most likely outcome of any given attempt to quit smoking, with as many as 80-90 percent of those who attempt to quit returning eventually to smoking. Better methods for relapse prevention could significantly reduce smoking-related morbidity and mortality including cancer-related mortality. One of the strongest predictors of relapse is a single smoking episode after quitting. However, there has been little research designed to illuminate the mechanism underlying this lapse- relapse association or indeed to determine whether there is a causal relationship at all. In order to more fully understand the relationship between lapse and relapse, it is necessary to conduct systematic research. Extremely useful in this regard would be a short-term model of cessation and relapse that would allow for controlled manipulation of smoking lapse and tracking of outcomes over a relatively brief time. Such a model would significantly enhance efficiency of data gathering over that available in lengthy and expensive clinical trials designs. This project proposes to follow up on a previous study conducted in our laboratory that utilized a short-term model of cessation and relapse to investigate the effects of programmed lapses during early smoking abstinence (Chornock et al., 1992). Specifically, we propose to a) examine cessation and relapse outcomes in a simulated quit model that uses monetary incentives to slow the relapse process, b) examine experimental lapse effects in the simulated quit model and c) determine the role of nicotine exposure in effects of smoking lapse by comparing effects of exposure to nicotine-containing and nicotine free cigarettes. Overall, the project will improve our understanding of smoking relapse and the variables that influence this process. In particular, new short-term models of cessation and relapse will be developed. Further, valuable information will be obtained about the potentially powerful effects of smoking after brief periods of abstinence (lapse) using these new models.