Biobehavioral Mechanisms of Concurrent Tobacco and Khat*

描述（由申请人提供）： 发展中国家烟草使用和成瘾的流行率急剧上升，这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，必须查明促进和维持这一成瘾的社会心理和生物化学因素，并随后制定有效的方法来解决这一问题，也门及其邻国的情况特别严峻，并因同时使用阿拉伯茶而复杂化，阿拉伯茶是一种男女都广泛使用的精神兴奋剂。也门是一个低收入国家，具有独特的战略特点，位于一组文化和语言相似的国家的中心，需要努力减少烟草使用。该提案的长期目标是制定一个多学科研究方案，重点是也门烟草成瘾和同时使用阿拉伯茶的生物行为机制。FIRCA建议的具体目标是确定激素，血液动力学和情绪变化，在休息期间，并在响应急性行为应激源之间的依赖性烟草使用者和非用户谁是或不是定期阿茶用户。该设计将包括4个群体：烟草和阿拉伯茶使用者、仅烟草使用者、仅阿拉伯茶使用者和不使用任何一种药物的人。在戒烟或随意吸烟后，将在两个独立的日期进行的两次平衡会议中收集测量结果。在每次治疗前24小时内，还将获得动态皮质醇和戒断症状的自我报告措施。我们将包括男子和妇女，因此将审查烟草和阿拉伯茶使用者对心理压力反应的性别差异。该项目将是制定可持续研究方案的第一阶段，重点是了解和打击也门及周边地区的烟草成瘾和同时使用阿拉伯茶。研究结果将提高我们对并发成瘾的基本认识，从而帮助我们制定有效的预防和治疗这些成瘾的方法。这项工作也与其他国家关注并发成瘾行为的研究有关。减少烟草流行和减少同时使用其他物质的成功努力将对全球健康和安全产生重大的积极影响。

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.