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卫生问题。仅在美国，吸烟是导致可预防死亡的首要原因，并与心脏病和肺癌等一系列慢性疾病有关。与此类健康后果相关的个人和联邦财政费用仍然是一项经济负担。尽管在戒烟干预发展方面取得了进展，但现有的干预措施仍有很大的改进空间。对吸烟维持和复吸背后的生物行为过程的基础研究可能是制定有效策略以减少吸烟问题的最佳指导。尼古丁戒断是痛苦耐受性低的个体戒烟失败的主要预测因素之一。具体来说，急性戒断症状，包括焦虑、易怒和抑郁情绪，似乎是那些反应性升高和对痛苦体验状态易感性的人早期失忆的原因。此外，来自观察性和干预性吸烟研究的证据表明，早期戒烟者完全戒烟的风险很高，这表明低DT吸烟者是一个需要针对戒烟进行专门干预的风险群体。在低DT吸烟者中，减少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，在戒断期间（戒烟后2-24小时），皮质醇的急剧下降被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，一种以正念为基础的身体活动形式，作为一种有前途的策略，可以调节皮质醇浓度，减少戒断症状，增加DT，从而促进戒烟成功。是否有规律的瑜伽练习可以有效调节低DT吸烟者的皮质醇，从而降低尼古丁戒断严重程度尚不清楚。因此，本研究是一项基础实验[主要考察瑜伽减少皮质醇和尼古丁戒断症状，同时增强DT的功效]。第二个目的是测试皮质醇调节作为一个假定的中介，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，这项拟议的研究将获得瑜伽的优势，而不是在自我指导戒烟后的两周内等待的效果大小。通过研究尼古丁戒断背后的关键生物行为机制（如皮质醇调节、痛苦耐受性），该研究方向的长期目标是：(1)为尼古丁戒断的理论模型提供信息；(2)指导在戒烟尝试后的最初几周内容易失效和复发的吸烟者制定有效的替代干预措施；(3)指导在戒烟背景下调节皮质醇调节的行为干预策略。

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.