Biobehavioral Mechanisms Underlying Yoga's Effects on Nicotine Withdrawal

瑜伽影响尼古丁戒断的生物行为机制

• 批准号: 8786369
• 负责人: Johnna Medina
• 金额: $ 3.8万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8786369
• 关键词: Abstinence; Accounting; Acute; Address; Anxiety; Area; Attenuated; Basic Science; Behavior Therapy; Behavioral; Behavioral Mechanisms; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic Disease; Cigarette; Data; Depressed mood; Development; Disease; Distress; Economic Burden; Exercise; Exhibits; Failure; Fibromyalgia; Financial cost; Glucocorticoids; Hair; Health; Heart Diseases; Hour; Hydrocortisone; Individual; Intervention; Journals; Left; Literature; Maintenance; Malignant Neoplasms; Malignant neoplasm of lung; Mediator of activation protein; Mental Depression; Nicotine; Nicotine Withdrawal; Participant; Pathway interactions; Patient Self-Report; Physical activity; Population; Populations at Risk; Predisposition; Process; Protocols documentation; Public Health; Randomized; Regulation; Relapse; Relative (related person); Remittance; Reporting; Research; Rest; Risk; Salivary; Severities; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Sports; Stress; Substance Addiction; Symptoms; Target Populations; Testing; Theoretical model; Time; United States; Withdrawal; Withdrawal Symptom; Yoga; base; biobehavior; body-mind; craving; deprivation; distress tolerance; effective intervention; high risk; hypothalamic-pituitary-adrenal axis; improved; mindfulness; mortality; non-smoker; post intervention; prevent; research study; response; smoking cessation; smoking intervention; smoking prevalence; smoking relapse; success; therapy development

DESCRIPTION (provided by applicant): Smoking represents a major public health problem worldwide. In the United States alone, smoking is the leading cause of preventable death and is associated with a host of chronic diseases, such as heart disease and lung cancer. Personal and federal financial costs associated with such health consequences remain an economic burden. Despite advances in the area of smoking cessation intervention development, existing interventions leave ample room for improvement. The development of effective strategies to reduce the smoking problem may be best guided by basic research on the bio-behavioral processes underlying smoking maintenance and relapse. Nicotine withdrawal is one major predictor of cessation failure for individuals low in distress tolerance (DT). Specifically, symptoms of acute withdrawal, including anxiety, irritability, and depressed mood, appear responsible for early lapse among those with elevated reactivity and susceptibility to distressing experiential states. Additionally, evidence from both observational and intervention smoking research suggests that early lapsers are at high risk for full smoking remittance, identifying low DT smokers as an at-risk group in need of specialized interventions targeting withdrawal. Reducing nicotine withdrawal-related distress and relapse in low DT smokers may require the regulation of cortisol. Basic research suggests steeper declines in cortisol during withdrawal (2-24 hours post-cessation), explained as an offset effect caused by nicotine deprivation, are directly related to withdrawal symptom intensity, subjective distress, and early lapse. Regular practice of yoga, a mindfulness-based form of physical activity, emerges as a promising strategy for regulating cortisol concentrations, decreasing withdrawal symptoms, and increasing DT, thus promoting smoking cessation success. Whether regular yoga practice can effectively regulate cortisol in smokers with low DT and thereby reduce nicotine withdrawal severity is unknown. Accordingly, the proposed study represents a basic experiment [primarily examining the efficacy of yoga to reduce cortisol and nicotine withdrawal symptoms, while enhancing DT. The secondary aim is to test] cortisol regulation as a putative mediator underlying the effects of an 8 week yoga intervention on nicotine withdrawal symptom severity in low DT smokers. [Finally, the proposed study will obtain effect sizes for the advantage of yoga over waitlist for lapses during a two-week period following a self-guide quit attempt.] By studying key bio-behavioral mechanisms (e.g., cortisol regulation, distress tolerance) underlying nicotine withdrawal, the long-term objectives of the proposed line of research hope to: (1) inform theoretical models of nicotine withdrawal, (2) guide the development of effective alternative interventions for smokers susceptible to lapse and relapse during the first few weeks following a quit attempt, and (3) guide behavioral intervention strategies to regulate cortisol regulation in the context of smoking cessation.

描述（由申请人提供）：吸烟是全球主要的公共卫生问题。仅在美国，吸烟是可预防死亡的主要原因，并与心脏病和肺癌等一系列慢性病有关。与这种健康后果有关的个人和联邦财政费用仍然是一种经济负担。尽管在戒烟干预开发领域取得了进展，但现有的干预措施仍有很大的改进空间。制定有效的策略，以减少吸烟问题可能是最好的指导基础研究的生物行为过程的基础上吸烟的维持和复发。尼古丁戒断是痛苦耐受力（DT）低的个体戒烟失败的一个主要预测因素。具体来说，急性戒断症状，包括焦虑，易怒，抑郁情绪，似乎负责早期失效的那些反应性和敏感性升高的痛苦体验状态。此外，来自观察性和干预性吸烟研究的证据表明，早期戒烟者完全吸烟汇款的风险很高，将低DT吸烟者确定为需要针对戒断的专门干预措施的高危人群。减少低DT吸烟者尼古丁戒断相关的痛苦和复发可能需要调节皮质醇。基础研究表明，在戒断过程中（戒烟后2-24小时）皮质醇的急剧下降，解释为尼古丁剥夺引起的抵消效应，与戒断症状强度，主观痛苦和早期失效直接相关。定期练习瑜伽，一种基于正念的身体活动形式，成为调节皮质醇浓度，减少戒断症状和增加DT的有希望的策略，从而促进戒烟成功。定期的瑜伽练习是否可以有效地调节低DT吸烟者的皮质醇，从而降低尼古丁戒断的严重程度尚不清楚。因此，拟议的研究代表了一个基本的实验[主要是检查瑜伽减少皮质醇和尼古丁戒断症状的功效，同时增强DT。第二个目的是测试皮质醇调节作为一种假定的介质，在低DT吸烟者中，8周瑜伽干预对尼古丁戒断症状严重程度的影响。[最后，拟议的研究将获得自我引导戒烟尝试后两周内瑜伽相对于等候名单的优势的效应大小。]通过研究关键的生物行为机制（例如，皮质醇调节，痛苦耐受）的基础尼古丁戒断，长期目标的建议线的研究希望：（1）为尼古丁戒断的理论模型提供信息，（2）为在尝试戒烟后的前几周内容易出现戒断和复吸的吸烟者制定有效的替代干预措施提供指导，（3）指导行为干预策略，调节戒烟背景下的皮质醇调节。