Tobacco Craving in Smokers with Schizophrenia

说明(申请人提供)：吸烟继续对发病率和死亡率产生重大影响，尽管试图教育吸烟者并改进戒烟干预措施。精神分裂症患者比普通人群面临更大的有害影响风险，这是因为精神分裂症患者吸烟的比例很大(60%-70%)。这部分人群更有可能是吸烟量较大的人，开始吸烟的可能性是普通人群的三倍，戒烟的可能性是普通人群的五倍。渴望是戒烟的一个重要障碍，精神分裂症患者的体验可能与普通人群不同。这项K23指导研究以患者为导向的职业发展奖由首席研究员Heidi Wehring博士提交，重点是渴望和测试一种针对患有精神分裂症的吸烟者的新型渴望干预。这一重点非常符合NIDA关于精神障碍患者药物滥用和治疗的五年战略计划，并与NIH的使命一致，即通过支持了解精神、成瘾和身体障碍的研究来促进发现、创新研究战略及其应用。韦林博士有一个长期的职业目标，那就是成为一名独立的研究人员，为被诊断为双重药物使用障碍的精神分裂症患者进行治疗研究，特别是确定应对尼古丁戒断挑战的新方法。这可以通过研究更好地定义渴望、禁欲和其他可能成为药理学或非药理学干预目标的因素来实现。这份K23提案既有研究和培训的目的和目标。短期目标包括对精神分裂症渴望研究领域的贡献，以及韦林博士作为独立研究员的发展。这些目标将通过一项研究计划来实现，该研究计划旨在进一步确定精神分裂症吸烟者烟草渴望的成分，通过一项试点研究确定米诺环素对香烟渴望和吸烟强度的影响，并确定精神分裂症吸烟者渴望、吸烟强度和对个性化线索/触发因素的反应之间的关系。Wehring博士将得到迪安娜·凯利博士和斯蒂芬·海什曼博士的指导，前者是精神分裂症、临床试验和双重诊断方面的专家，后者是烟草、尼古丁药理学和线索引起的渴望方面的专家，后者是生物统计学和研究设计专家罗伯特·麦克马洪博士和A.Eden Evins，他们在精神分裂症中使用尼古丁方面具有专业知识。Wehring博士还将在K颁奖期间继续进行课程学习，以增加技能并发展成为独立调查员所需的专业知识。该项目将提供试点数据，以建立未来的研究，重点是发展对精神分裂症患者戒烟的干预措施。这一点至关重要，因为对物质使用的基本方面的了解将有助于制定有效的干预措施。

DESCRIPTION (provided by applicant): Cigarette smoking continues to have a major impact on morbidity and mortality, despite attempts to educate smokers and to improve smoking cessation interventions. Persons with schizophrenia are at greater risk for deleterious effects than the general population, due to the large percentage of persons with schizophrenia (60%-70%) who smoke cigarettes. This subset of the population are more likely to be heavier smokers, are three times more likely to start and five times less likely to quit smoking than people in the general population. Craving is a significant barrier to cessation, and may be experienced differently by persons with schizophrenia compared to the general population. This K23 mentored-research patient oriented career development award, submitted by Principal Investigator Dr. Heidi Wehring, focuses on craving and testing a novel craving intervention for smokers with schizophrenia. This focus fits well within the NIDA 5-Year Strategic Plan regarding substance abuse and treatment in persons with co-occurring mental disorders, and is consistent with the NIH mission to foster discoveries, innovative research strategies, and their applications by supporting research in the understanding of mental, addictive, and physical disorders. Dr. Wehring has a long-term career goal of becoming an independent investigator of treatment research for persons with schizophrenia who are dually diagnosed with a substance use disorder, specifically to determine novel approaches to the challenge of nicotine cessation. This may be done through using research to better define craving, abstinence, and other factors that may be targeted by pharmacological or nonpharmacological interventions. This K23 proposal has both research and training aims and goals. Short-term goals include contributions to the field of craving research in schizophrenia and Dr. Wehring's development as an independent investigator. These goals will be accomplished by a research proposal aiming to further define components of tobacco craving in smokers with schizophrenia, to determine the effects of minocycline on cigarette craving and smoking intensity via a pilot study, and to determine the relationship between changes in craving, smoking intensity, and responses to individualized cues/triggers to craving in smokers with schizophrenia. Dr. Wehring will be mentored by Dr. Deanna Kelly, an expert in schizophrenia, clinical trials, and dual diagnosis, and Dr. Stephen Heishman, an expert in tobacco, nicotine pharmacology, and cue-elicited craving, and will benefit from the support of Consultants Dr. Robert McMahon, an expert in biostatistics and research design and A. Eden Evins, with expertise in nicotine use in schizophrenia. Dr. Wehring will also pursue coursework during the K award period to increase skills and develop expertise necessary to become an independent investigator. This project will provide pilot data to build future research focusing on the development of interventions for smoking cessation in persons with schizophrenia. This is of paramount importance, as the understanding of underlying aspects of substance use will be instrumental in creation of effective interventions.