Advancing addiction research and capacity to guide tobacco control in the Eastern

推进成瘾研究和指导东部地区烟草控制的能力

• 批准号: 9117533
• 负责人: Wasim Maziak
• 金额: $ 30.3万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9117533
• 关键词: Accounting; Address; Adopted; Advocacy; Appearance; Assessment tool; Attitude; Cessation of life; Cigarette; Cigarette Smoker; Clinical; Cognitive; Communities; Cues; DSM-IV; Dependence; Developing Countries; Development; Diagnosis; Disease; Early Intervention; Educational workshop; Epidemic; Exposure to; Failure; Family; Funding; Grant; Health; Health Policy; Incubators; Institutes; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Intervention; Knowledge; Maintenance; Malignant Neoplasms; Mediterranean Region; Mentorship; Methods; Modeling; Monitor; Monodon; Morbidity - disease rate; National Institute of Drug Abuse; Negative Reinforcements; Nicotine Dependence; Outcome; Pattern; Pharmaceutical Preparations; Pipe smoker; Plant Roots; Policies; Positive Reinforcements; Process; Product Labeling; Property; Public Health; Recruitment Activity; Regulation; Research; Research Personnel; Risk; Science; Seeds; Sensory; Smoker; Smoking; Social Welfare; Symptoms; Syndrome; Syria; Testing; Theoretical model; Time; Tobacco; Tobacco Dependence; Tobacco smoking; Tobacco use; Training; Training Programs; Withdrawal Symptom; Withholding Treatment; Work; Youth; addiction; base; cigarette smoking; cohort; contextual factors; coping; design; evidence base; experience; grasp; hookah; instrument; longitudinal design; mortality; non-smoker; pipe smoking; relapse risk; social; social learning; therapy development; tobacco control; tool; trend

DESCRIPTION (provided by applicant): Tobacco smoking continues to be the number 1 preventable cause of morbidity and mortality, contributing to millions of deaths every year and wreaking havoc on the welfare of families and communities worldwide. Although smokers are usually aware of smoking risks, they find quitting difficult due to the formidable grip of nicotine dependence (ND). So far, ND research has primarily focused on cigarettes, yet for many youth worldwide, tobacco addiction can be maintained by means other than the cigarette. In particular, over the past decade, water pipe (WP) smoking (a.k.a. hookah, shisha, narwhal) has dramatically become a worldwide phenomenon among youth. WP's worrisome trends have been monitored closely at the Syrian Center for Tobacco Studies (SCTS), where some of the pioneer evidence about its harmful and addictive properties was generated. Despite this, evidence-based solutions to the WP epidemic still lag behind. Obviously, interventions are needed to discourage WP initiation among youth, treat dependent WP smokers, and advance policy and product regulations. Unfortunately, this is hindered in part by the lack of knowledge on how ND develops and manifests in WP smokers. Characterizing ND in WP smokers will help guide the timing and composition of cessation treatments, as well as to counter deceptive product labeling, and drive public health policies to limit WP promotion and youth access. Most studies of ND in WP smokers to date are limited by cross sectional designs, instruments that are geared towards the cigarette, or failure to account for important personal and contextual factors. Thus, an approach that is rooted in common theoretical models of ND, and applies WP- sensitive tools within a longitudinal design has the potential of capturing the full spectrum of ND in young WP smokers. We will adopt this approach to test the following hypotheses: (1) symptoms of ND will appear despite intermittent use patterns in the majority of WP smokers and will predict important clinical outcomes (failed quitting, escalation), (2) the trajectory of ND inWP smokers differs from that of cigarette, and (3) the progression to ND in WP smokers is influenced by personal and contextual factors. For this purpose, we will recruit 250 WP smokers and nonsmokers susceptible to WP, and similar numbers for cigarettes, from 10th graders in Aleppo-Syria (H15 years at baseline) and follow them twice/year for 3 yrs. We plan to test these hypotheses by 1- detecting the first symptoms and diagnosis of ND among WP smokers, 2- comparing common trajectories of ND symptoms among WP smokers, cigarette smokers, and dual smokers, and 3- determining factors that predict ND development in young WP smokers. This project will allow us also to train researchers in Syria and the EMR in tobacco addiction science through a combination of training workshops, seed grants, and extended mentorship. We hope through this project to gain experience about ND in young WP smokers that can guide the development of interventions to reduce WP use and curtail WP-related morbidity and mortality.

说明(申请人提供)：吸烟仍然是发病率和死亡率的头号可预防原因，每年导致数百万人死亡，并对世界各地家庭和社区的福利造成严重破坏。尽管吸烟者通常意识到吸烟的风险，但由于尼古丁的强大吸引力，他们发现很难戒烟。 依赖性(ND)。到目前为止，ND的研究主要集中在香烟上，但对于世界各地的许多年轻人来说，烟草成瘾可以通过香烟以外的方式保持。特别是，在过去的十年里，水烟(WP)(也就是水烟、水烟、独角鲸)在年轻人中戏剧性地成为一种世界性的现象。可湿性粉剂令人担忧的趋势一直受到叙利亚烟草研究中心(SCTS)的密切关注，一些关于其有害和令人上瘾的特性的先驱证据就是在那里产生的。尽管如此，针对可湿性粉病流行的循证解决方案仍然落后。显然，需要采取干预措施来阻止年轻人发起可湿性粉剂，治疗依赖可湿性粉剂的吸烟者，并推进政策和产品法规。不幸的是，这在一定程度上受到了缺乏对新城疫如何在可湿性粉尘吸烟者中发展和表现的了解的阻碍。确定可湿性粉剂吸烟者的ND特征将有助于指导戒烟治疗的时机和组成，以及打击欺骗性的产品标签，并推动公共卫生政策限制可湿性粉剂的推广和青少年接触。到目前为止，大多数关于可湿性粉尘吸烟者ND的研究都受到横断面设计、针对香烟的仪器或未能考虑重要的个人和背景因素的限制。因此，植根于ND的常见理论模型并在纵向设计中应用WP敏感工具的方法具有捕获ND的全谱的潜力 在年轻的可湿性粉剂吸烟者中。我们将采用这种方法来检验以下假设：(1)在大多数可湿性粉剂吸烟者中，尽管间歇性使用模式，ND症状仍会出现，并将预测重要的临床结果(戒烟失败、病情升级)；(2)可湿性粉剂吸烟者的ND轨迹不同于香烟吸烟者；(3)可湿性粉剂吸烟者向ND的进展受个人和环境因素的影响。为此，我们将招募250名可湿性粉剂吸烟者和易患可湿性粉剂的非吸烟者，并从阿勒颇-叙利亚的10年级学生(基线为H15岁)招募类似数量的可湿性粉剂吸烟者，并每年跟踪他们两次，为期3年。我们计划通过1-检测WP吸烟者中ND的首发症状和诊断，2-比较WP吸烟者、吸烟者和双重吸烟者中ND症状的共同轨迹，以及3-预测年轻WP吸烟者ND发展的决定因素来检验这些假设。该项目还将使我们能够通过培训讲习班、种子赠款和延长指导的组合，对叙利亚和EMR的研究人员进行烟草成瘾科学方面的培训。我们希望通过这个项目，在年轻的可湿性粉尘吸烟者中获得关于ND的经验，以指导制定干预措施，减少可湿性粉剂的使用，减少与可湿性粉剂相关的发病率和死亡率。