Treatment of Complex Patients: Emphasis on Nicotine

描述（由申请人提供）：本竞争性更新K 05提案的目标是继续支持我在尼古丁依赖治疗方面的研究，进一步提高我指导初级科学家和培训博士后学者的能力，使我能够通过研究中心管理继续发挥科学领导作用，并将研究结果传播给科学和临床界。自上次提交该奖项以来，我已发表、出版或正在审查62篇科学论文。我完成了一项临床试验（N=322）的创新干预抑郁症吸烟者在精神科门诊，研究戒烟及其对心理健康的影响，以及干预的成本效益。根据提议，我正在完成两项主要的临床试验：（1）一项长期行为复发预防和安非他酮治疗慢性吸烟者的研究（N=407）;（2）一项长期、特定年龄复发预防和尼古丁替代治疗老年吸烟者的研究（N=403）。这两项研究中的延长治疗条件在一年内产生了53%至42%的生物学证实的戒断率。最重要的是，这些比率在2年随访时没有变化;它们精确地保持在1年时观察到的水平。我继续指导P50中心的拨款，重点是治疗复杂患者，重点是尼古丁。此外，我还与其他科学家开展了合作，他们大多是我的学生。这项工作包括针对目标人群和共病吸烟者的烟草依赖治疗研究。此外，我与其他科学家合作研究吸烟者对安非他酮的遗传反应，以及减少尼古丁香烟的影响。如果这个奖项得到资助，我将继续我的工作在扩展治疗，研究在医疗保健环境中的实施，并开发和测试基于技术的适应它。我将继续我的领导作用，在P50赠款和博士后培训补助金，并将继续与其他教师，特别是初级教师合作。我有指导初级教师的历史，可以追溯到获得这个奖项之前。我也将继续我的指导作用，并增加我的指导初级教师，新的教师招聘，新的部门指导计划的实施和加强。最后，我将继续我的工作与个别博士后学员。

DESCRIPTION (provided by applicant): The goal of this competing renewal K05 proposal is to continue to support my research in the treatment of nicotine dependence, to further my capacity to mentor junior scientists and train postdoctoral scholars, to allow me to continue in scientific leadership through research center administration, and to disseminate research findings to the scientific and clinical community. Since this award was last submitted, I have published, in press, or under review 62 scientific papers. I completed a clinical trial (N=322) of an innovative intervention for depressed smokers in a psychiatric outpatient clinic, studying both smoking abstinence and its impact on mental health, and the cost-effectiveness of the intervention. As proposed, I am completing two major clinical trials: (1) a study of extended behavioral relapse prevention and bupropion treatment for chronic smokers (N=407); (2) a study of extended, age-specific relapse prevention and nicotine replacement treatment for older smokers (n=403). Extended treatment conditions in these two studies have produced biologically confirmed abstinence rates from 53 to 42% at one year. Of greatest importance, these rates do not change at two year follow-up; they remain at precisely the level observed at one year. I continued to direct a P50 center grant that focuses on Treatment of Complex Patients with an emphasis on nicotine. In addition, I have developed collaborations with other scientists, who are mostly my mentees. This work includes tobacco dependence treatment studies for targeted populations and for co-morbid smokers. In addition, I collaborate with other scientists of the genetics of bupropion response in smokers, and on the effects of reduced nicotine cigarettes. If this award is funded, I will continue my work on extended treatment, studying implementation in health care settings, and developing and testing technology based adaptations of it. I will continue my leadership role in the P50 grant and in the postdoctoral training grant, and will continue to collaborate with other faculty, especially junior faculty. I have a history of mentoring junior faculty that extends back well before the receipt of this award. I will also continue my mentoring role, and increase my mentoring of junior faculty, as new faculty are recruited, and the new departmental mentoring program is implemented and enhanced. Last, I will continue my work with individual postdoctoral trainees.