STRESS RESPONSE AND SMOKING CESSATION IN DEPRESSED YOUTH

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Cigarette smoking frequently begins in adolescence and is associated with significant socioeconomic and psychosocial burden, highlighting the need for early and effective intervention. Despite evidence for efficacy of pharmacological agents, particularly some anti-depressant(AD) drugs, in adults, these treatments for smoking cessation have not been studied in youngsters, nor has it been studied which population of youth would benefit most from the treatments. In considering the mechanisms of action of AD drugs in smoking cessation, the HPA axis may be important for investigation. the magnitude of HPA response to stress and/or to nicotine administration has been shown to modulate the progression to nicotine dependence. Also, there is a connection between HPA regulation and response to some AD drugs. Specific Aims: 1) To evaluate whether bupropion, an anti-depressant drug that also is a proven pharmacological treatment for smoking cessation adult smokers, is helpful in reducing smoking in depressed adolescents. 2) To examine whether hypothalamic-pituitary-adrenal (HPA) regulation is associated with smoking cessation in response to bupropion in this population. 3) To examine the association between smoking cessation and HPA activity changes in response to bupropion treatment in depressed adolescent smokers.