Reduced Nicotine Cigarettes in Smokers with and without Alcohol Use Disorder

项目总结 饮酒和吸烟是密切相关的。患有DSM-5当前酒精使用障碍(AUD)的成年人 吸烟的人产生不良健康后果的风险显著增加 戒烟失败。减少香烟中的尼古丁含量被认为是一种 促进戒烟和改善公众健康的战略，但尚未有研究 评估吸烟的AUD成年人对尼古丁香烟(RNC)减少的反应。 这样的研究还可以测试潜在的行为机制的密切联系 饮酒和吸烟，为未来的综合干预提供信息，旨在减少 既喝酒又抽烟。目前的提案审查了对两个RNC的反应，其中一个是Low 尼古丁含量(RNC低；0.12 mg)和中等尼古丁含量(RNC中； 0.8 mg)在有和没有AUD的每日吸烟者。参与者(N=70)将参加总共五个 参观实验室。第一次访问将把参与者归类为澳元(n=35)或非 AUD(n=35)，并收集基线数据。参与者将被指派接受两次 实验条件(即，在家中低或中等程度的RNC独家吸烟 环境7天)采用双盲、随机、交叉设计。这两个实验 参赛者将在7天内重新吸食自有品牌的 香烟。在两个实验条件的第一天和最后一天，参与者将 在实验室中吸烟指定的RNC，以及关于毒物暴露的数据(即，呼气增加 一氧化碳、血浆尼古丁和可替宁；烟头中的茄尼醇)， 主观可接受性(即主观反应；风险感知；相对强化效能)； 以及与吸烟的RNC相关的吸烟补偿(即，吸烟地形测量) 将会被收取。在与RNC接触的每7天期间，参与者将提供 关于酒精和尼古丁使用、尼古丁戒断、吸烟冲动和酒精冲动的日常数据 基于电话的交互式语音响应技术。我们书房设计的优势在于 我们既可以评估组间(即AUD与非AUD)，也可以评估个人内(即RNC 低与中等)的差异对RNC的反应，并且，此外，可以检查 尼古丁戒断、吸烟冲动和酒精冲动的增加在 减少尼古丁暴露和饮酒。这项研究的结果将表明 饮酒和吸烟的机制可能需要在未来的综合研究中加以解决 对这两个问题的干预，并将立即通知实际执行 全市场范围内澳元吸烟者的尼古丁含量下降。

PROJECT SUMMARY Drinking and smoking are closely related. Adults with DSM-5 current alcohol use disorder (AUD) who smoke cigarettes are at significantly elevated risk for adverse health outcomes and smoking cessation failure. Reduction in cigarette nicotine content has been proposed as a strategy to promote smoking cessation and improve public health, yet studies have not yet evaluated how adults with AUD who smoke respond to reduced nicotine cigarettes (RNCs). Such studies can also test behavioral mechanisms underlying the close association between drinking and smoking, providing information for future integrated interventions that aim to reduce both drinking and smoking. The current proposal examines response to two RNCs, one with low nicotine content (RNC Low; 0.12mg) and one with moderate nicotine content (RNC Moderate; 0.8mg) in daily smokers with and without AUD. Participants (N = 70) will attend a total of five visits to the laboratory. The first visit will be to classify participants as either AUD (n = 35) or Non AUD (n = 35) and gather baseline data. Participants will be assigned to undergo two experimental conditions (i.e., exclusive smoking of RNC Low or Moderate in their home environment for 7 days) in a double-blind, randomized, crossover design. The two experimental conditions will be separated by a 7-day period of return to smoking of participants’ own brand of cigarette. On the first and last day of each of the two experimental conditions, participants will smoke the assigned RNC in the laboratory, and data on toxicant exposure (i.e., boost in exhaled carbon monoxide and plasma nicotine and cotinine; solanesol from smoked cigarette butts), subjective acceptability (i.e., subjective response; risk perceptions; relative reinforcing efficacy); and smoking compensation (i.e., smoking topography measures) related to the smoked RNC will be collected. During each 7-day period of exposure to the RNCs, participants will provide daily data on alcohol and nicotine use, nicotine withdrawal, smoking urge, and alcohol urge via telephone-based Interactive Voice Response technology. The strength of our study design is that we can evaluate both between-group (i.e., AUD vs. Non AUD) and within-person (i.e., RNC Low vs. Moderate) differences in response to RNCs and, furthermore, can examine whether increased nicotine withdrawal, smoking urge, and alcohol urge mediate the relation between decreased nicotine exposure and alcohol consumption. Results from this study will show what mechanisms underlying drinking and smoking may need to be addressed in future integrated interventions for both problems and will immediately inform the practical implementation of market-wide reductions in cigarette nicotine content among smokers with AUD.