Biobehavioral Mechanisms of Concurrent Tobacco and Khat*

描述(由申请人提供)： 有记录表明，发展中国家的烟草使用和成瘾情况急剧上升，增加了对这些国家的健康和可持续经济发展造成严重后果的威胁。为了减缓这一流行病，重要的是确定促进和维持这种成瘾的心理社会和生化因素，并随后开发有效的方法来解决它。也门和邻国的局势尤其严峻，由于同时使用阿拉伯茶，这是一种男性和女性都广泛使用的精神刺激药物。也门是一个低收入国家，具有独特的战略特征，处于一组文化和语言相似的国家的中心位置，需要努力减少烟草使用。这项提议的长期目标是开发一项多学科研究计划，重点关注烟草成瘾的生物行为机制和也门同时使用阿拉伯茶的情况。FIRCA建议的具体目标是确定在依赖烟草使用者和非经常使用阿拉伯茶的吸烟者中，在休息和应对急性行为应激时荷尔蒙、血流动力学和情绪的变化。该设计将包括4组：烟草和阿拉伯茶使用者，仅烟草使用者，仅阿拉伯茶使用者，以及那些不使用这两种药物的人。在戒烟或随意吸烟后，将在两个不同的日子举行两次平衡会议，收集措施。还将在每次治疗前24小时内获得动态皮质醇和戒断症状自我报告测量。我们将包括男性和女性，因此，我们将审查烟草和阿拉伯茶使用者在应对心理压力方面的性别差异。该项目将是制定可持续研究方案的第一阶段，该方案将侧重于了解和打击烟草成瘾以及在也门和周边地区同时使用阿拉伯茶。这一结果将提高我们对并发成瘾的基本理解，并随后帮助我们开发有效的方法来预防和治疗这些成瘾。这项工作也与其他国家关注同时成瘾行为的研究有关。成功地努力减少烟草流行和减少同时使用其他物质将对全球健康和安全产生重大积极影响。

DESCRIPTION (provided by applicant): A dramatic escalation in the prevalence of tobacco use and addiction in developing countries has been documented, increasing the threat of grave consequences for health and for sustainable economic development in these countries. In order to slow this epidemic, it is important to identify psychosocial and biochemical factors that promote and maintain this addiction, and to subsequently develop effective methods to address it. The situation in Yemen and in neighboring countries is particularly grim and complicated by the concurrent use of khat, a psychostimulant drug widely used by both men and women. Yemen is a low-income country with unique strategic characteristics, being centrally located within a group of culturally and linguistically similar countries in need of efforts to reduce tobacco use. The long-term goal of this proposal is to develop a multidisciplinary research program focusing on biobehavioral mechanisms of tobacco addiction and the concurrent use of khat in Yemen. The specific goal of this FIRCA proposal is to determine hormonal, hemodynamic, and mood changes during rest and in response to acute behavioral stressors among dependent tobacco users and non-users who are or are not regular khat users. The design will include 4 groups: tobacco and khat users, tobacco users only, khat users only, and those who do not use either drug. Measures will be collected in two counterbalanced sessions conducted on two separate days, after abstinence or ad libitum tobacco use. Ambulatory cortisol and self-report measures of withdrawal symptoms will also be obtained during the 24-hour period prior to each session. We will include men and women, and will, therefore, examine gender differences in responses to psychological stress among tobacco and khat users. The project will represent a first stage towards developing a sustainable research program that will focus on understanding and combating tobacco addiction and concurrent use of khat in Yemen and the surrounding region. The results will improve our basic understanding of concurrent addictions and subsequently help us develop effective methods for prevention and treatment of these addictions. This work is also relevant to research focusing on concurrent addictive behaviors in other countries. Successful efforts to reduce the tobacco epidemic and to reduce concurrent use of other substances will have a significant positive impact on global health and security.