Enhancing Tobacco Use Treatment for African American Light Smokers

加强对非裔美国轻度吸烟者的烟草使用治疗

• 批准号: 7885882
• 负责人: LISA SANDERSON COX
• 金额: $ 10.09万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-21 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7885882
• 关键词: Abstinence; African American; Biological; Blood; Bupropion; CYP2B6 gene; Characteristics; Cigarette; Cities; Clinic; Collaborations; Communities; Cotinine; Counseling; Dose; Double-Blind Method; Drug usage; Foundations; General Population; Genetic; Genetic Polymorphism; Genetic Variation; Genotype; Goals; Health; Health Promotion; Health education; Individual; Institution; Intervention; Intervention Studies; Investigation; Kansas; Light; Measurable; Measures; Metabolism; Methods; Missouri; Morbidity - disease rate; Nicotine; Outcome; Parents; Participant; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Phenotype; Placebo Control; Placebos; Prevalence; Psychosocial Factor; Randomized; Relapse; Relative (related person); Research; Research Personnel; Risk; Salivary; Sampling; Serum; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Smoking History; Tablets; Tobacco; Tobacco use; Treatment outcome; United States National Institutes of Health; Upper arm; Variant; active control; active method; base; behavior change; biobehavior; cytochrome P-450 CYP2A6 (human); design; drug metabolism; experience; genetic variant; hydroxycotinine; mortality; multidisciplinary; nicotine gum; nicotine replacement; primary outcome; programs; psychosocial; randomized placebo controlled trial; response; smoking cessation; smoking prevalence; treatment response

African Americans are at increased risk for tobacco related morbidity and mortality despite smoking fewer cigarettes per day than the general population. Within this competing continuation, our experienced, multidisciplinary team proposes to conduct collaborative research building upon a strong foundation of smoking cessation intervention studies among urban African American smokers. Our previous research demonstrated efficacy of bupropion for smoking cessation among moderate to heavy smokers, efficacy of health education counseling and limitations in nicotine gum use among light smokers. We plan to extend these efforts to further evaluate smoking behavior and biobehavioral interventions and to explorefactors associated with drug activity and behavior change with the goal of enhancing abstinence outcomes. Our specific objectives are to 1) evaluate the efficacy of sustained release bupropion in combination with health education (HE) counseling for smoking cessationamong urban African American light smokers, 2) characterize CYP2A6 activity by evaluating phenotype (3HC/cotinine ratio ) and CYP2A6 genotype, 3) characterize CYP2B6 activity by evaluating phenotype and CYP2B6 genotype to assess nicotine and bupropion metabolite levels, 4) explore associations of these phenotypic and genotypic variables with smoking cessation and response to bupropion. This randomized, placebo-controlled study will be conducted at a community-based clinic, Swope Parkway Health Center in Kansas City, Missouri. The primary outcome is 7-day point prevalence smoking abstinence at 6 months confirmed with salivary cotinine. Five hundred forty (270 in each arm) African American light smokers will be randomly assigned to an active bupropion and health education (HE) counseling (Tx) condition or to a placebo and HE comparison (C) condition. Bupropion treatment (active or placebo) will last for 7 weeks (one week prior to quit date, six weeks post quit date). All participants will be offered six HE sessions. The proposed research provides a unique opportunity to evaluate psychosocial and biological mechanisms related to drug use and treatment outcomes. Identifying ndividuals for whom treatments are most effective and, in contrast, identifying characteristics related to relapse risk will be critical to advancing tailored tobacco use treatment and health promotion for African American smokers.

尽管吸烟较少，非裔美国人与烟草相关的发病率和死亡率的风险却增加 每天吸烟量高于一般人群。在这个竞争的延续中，我们经验丰富、 多学科团队建议在坚实的基础上进行合作研究 城市非裔美国吸烟者的戒烟干预研究。我们之前的研究 已证实安非他酮对中度至重度吸烟者戒烟的功效， 健康教育咨询和轻度吸烟者使用尼古丁口香糖的限制。我们计划延长 这些努力是为了进一步评估吸烟行为和生物行为干预措施并探索因素 与药物活性和行为改变相关，以提高戒断结果。我们的 具体目标是 1) 评估缓释安非他酮与健康相结合的功效 针对城市非裔美国轻度吸烟者的戒烟教育 (HE) 咨询，2) 通过评估表型（3HC/可替宁比率）和 CYP2A6 基因型来表征 CYP2A6 活性，3) 通过评估表型和 CYP2B6 基因型来表征 CYP2B6 活性，以评估尼古丁和 安非他酮代谢物水平，4) 探索这些表型和基因型变量与 戒烟和对安非他酮的反应。这项随机、安慰剂对照研究将进行 在密苏里州堪萨斯城的一家社区诊所 Swope Parkway 健康中心。主要结果 是用唾液可替宁证实的 6 个月戒烟 7 天点患病率。五百 四十名（每组 270 名）非裔美国轻度吸烟者将被随机分配到服用活性安非他酮和 健康教育 (HE) 咨询 (Tx) 条件或安慰剂和 HE 比较 (C) 条件。安非他酮 治疗（活性药物或安慰剂）将持续 7 周（戒烟日期前 1 周，戒烟日期后 6 周）。全部 将为参与者提供六次高等教育课程。拟议的研究提供了一个独特的机会 评估与药物使用和治疗结果相关的心理社会和生物机制。识别 治疗最有效的个体，相反，确定与以下相关的特征 复吸风险对于推进非洲的定制烟草使用治疗和健康促进至关重要 美国吸烟者。