EVarQuit: Extinguishing cigarette smoking via extended pre-quit varenicline

EVarQuit：通过延长戒烟前伐尼克兰来戒烟

• 批准号: 9236849
• 负责人: LARRY W HAWK
• 金额: $ 76.14万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2021-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9236849
• 关键词: Abstinence; Adult; Agonist; Animal Experimentation; Behavioral; Binding; Biochemical; Biological; Cause of Death; Cessation of life; Cigarette; Clinical; Clinical Data; Cotinine; Counseling; Data; Development; Dopamine; Ecological momentary assessment; Exhibits; Expectancy; Extinction (Psychology); Female; Frequencies; Gender; Goals; Hawks; Human; Individual; Label; Laboratories; Learning; Life; Link; Malignant Neoplasms; Measures; Mediating; Mediation; Methods; Morbidity - disease rate; Nausea; Nicotine; Nicotinic Receptors; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Phase; Physicians; Physiological; Placebos; Process; Psychological reinforcement; Public Health; Randomized; Randomized Clinical Trials; Rattus; Relapse; Research; Research Support; Running; Self Administration; Smoke; Smoker; Smoking; Smoking Behavior; Testing; Time; Withdrawal; Woman; Work; base; cancer prevention; cigarette smoking; clinical efficacy; clinical practice; cost; craving; efficacy testing; follow-up; improved; mortality; next generation; novel therapeutics; pre-clinical; predictive modeling; primary outcome; smoking cessation; success; theories; varenicline

PROJECT SUMMARY/ABSTRACT Varenicline is the most effective smoking cessation therapy available. Nevertheless, most smokers using varenicline relapse within the first few months after quitting. Varenicline is hypothesized to help smokers to quit in part by reducing the reinforcing effects of smoking during the standard 1-week pre-quitting treatment phase. Learning theory and previous human and animal research support the hypothesis that a longer duration of varenicline treatment prior to the target quit date (TQD) will yield greater decreases in the number of cigarettes smoked per day before quitting, and higher long-term cessation rates, compared to standard varenicline treatment. Building on our promising preliminary clinical data, we propose to test these hypotheses with a full-scale randomized clinical trial (RCT). Four hundred treatment-seeking smokers (200 female) will be randomized to a standard run-in group (3 weeks of placebo, followed by the standard 1 week of pre-TQD varenicline) or an extended run-in group (4 weeks of pre-TQD varenicline). Both groups will receive brief individual cessation counseling and 11 weeks of post-TQD varenicline. The primary outcome measure will be bio-verified continuous abstinence at end-of-treatment (weeks 8-11 post-quit) and at long-term follow-up (weeks 8-26 and 8-52 post-quit). Hypothesized mediating mechanisms (e.g., smoking reinforcement) will be evaluated by converging behavioral, physiological, and subjective measures assessed both in the lab and using real-world, real-time electronic momentary assessments (EMA). We predict that long-term, bio-verified smoking cessation will be improved among the extended run-in group compared to the standard run-in group. We further predict the improved clinical outcomes with extended run-in varenicline will be explained (or mediated) by greater pre-quit reductions in smoking reinforcement among the extended run-in group compared to the standard run-in group. The significance of this work is clear: We aim to make best available treatment for smoking cessation even better, using a method that is ripe for dissemination and an approach that will elucidate critical mechanisms to target in the next generation of treatment enhancement.

项目概要/摘要 伐尼克兰是最有效的戒烟疗法。尽管如此，大多数 使用伐尼克兰的吸烟者在戒烟后的最初几个月内会复发。伐尼克兰是 假设通过减少吸烟的强化效应来帮助吸烟者戒烟 在标准的 1 周戒烟前治疗阶段。学习理论与前人类 和动物研究支持这样的假设：伐尼克兰治疗之前需要更长的持续时间 到目标戒烟日期 (TQD) 将大幅减少每人吸烟的数量 与标准伐尼克兰相比，戒烟前一天，长期戒烟率更高 治疗。基于我们有希望的初步临床数据，我们建议测试这些 全面随机临床试验（RCT）的假设。四百人寻求治疗 吸烟者（200 名女性）将被随机分配到标准磨合组（3 周安慰剂， 随后进行标准的 1 周 TQD 前伐尼克兰治疗）或延长磨合组（4 周） TQD 之前的伐尼克兰）。两组都将接受简短的个人戒烟咨询和 11 TQD 伐尼克兰后几周。主要结果指标将经过生物验证连续 治疗结束时（戒烟后第 8-11 周）和长期随访时（第 8-26 周）戒烟 以及戒烟后8-52）。假设的中介机制（例如，吸烟强化）将是 通过综合行为、生理和主观测量来评估 实验室并使用真实世界的实时电子瞬时评估 (EMA)。我们预测 经生物验证的长期戒烟效果将在延长磨合组中得到改善 与标准磨合组相比。我们进一步预测临床结果的改善 伐尼克兰的长期磨合将通过戒烟前的更大减少来解释（或介导） 与标准磨合组相比，延长磨合组的吸烟强化 团体。这项工作的意义很明确：我们的目标是为患者提供最佳的治疗方法 使用成熟的传播方法和途径可以更好地戒烟 这将阐明下一代治疗目标的关键机制 增强。