Biobehavioral Mechanisms Underlying Yoga's Effects on Nicotine Withdrawal

描述(由申请人提供)：吸烟是世界范围内的一个主要公共健康问题。仅在美国，吸烟就是可预防的死亡的主要原因，并与许多慢性病有关，如心脏病和肺癌。与这种健康后果相关的个人和联邦财政成本仍然是一种经济负担。尽管戒烟干预措施的发展取得了进展，但现有的干预措施仍有很大的改进空间。制定有效的策略来减少吸烟问题可能最好是通过对吸烟维持和复发背后的生物行为过程的基础研究来指导的。尼古丁戒断是低痛苦耐受性(DT)个体戒烟失败的一个主要预测因素。具体地说，急性戒断的症状，包括焦虑、易怒和抑郁情绪，似乎是那些反应性升高和容易出现痛苦体验状态的人早期失误的原因。此外，来自观察性和干预性吸烟研究的证据表明，早期失败者获得全额吸烟汇款的风险很高，这将低DT吸烟者确定为需要针对戒烟目标的专门干预的高危群体。减少低DT吸烟者与尼古丁戒断相关的痛苦和复发可能需要皮质醇的调节。基础研究表明，戒烟期间(戒烟后2-24小时)皮质醇水平急剧下降，这被解释为尼古丁剥夺导致的抵消效应，与戒断症状强度、主观痛苦和早期失误直接相关。定期练习瑜伽是一种基于正念的体力活动，是一种很有希望的策略，可以调节皮质醇浓度，减少戒断症状，增加DT，从而促进成功戒烟。定期练习瑜伽是否能有效地调节低dT吸烟者的皮质醇，从而降低尼古丁戒断的严重程度，目前尚不清楚。因此，这项拟议的研究代表了一项基础实验[主要考察了瑜伽在减少皮质醇和尼古丁戒断症状，同时提高DT方面的效果。第二个目的是测试皮质醇调节作为一种可能的中介，以此作为8周瑜伽干预对低DT吸烟者尼古丁戒断症状严重程度影响的潜在中介。[最后，这项拟议的研究将获得在自我指导戒烟尝试后的两周时间内，瑜伽相对于等待戒烟的优势的效果大小。]通过研究尼古丁戒断的关键生物行为机制(例如，皮质醇调节、痛苦耐受性)，拟议研究系列的长期目标希望：(1)提供尼古丁戒断的理论模型，(2)指导为戒烟尝试后最初几周内易犯错误和复发的吸烟者开发有效的替代干预措施，以及(3)指导行为干预策略，以调节戒烟背景下的皮质醇调节。

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.