A Mentoring Program in Patient-Oriented Tobacco Dependence and Implementation Science Research

尽管过去50年来在降低吸烟率方面取得了进展，但烟草使用仍然是主要原因

Despite progress over the past 50 years in lowering the rate of smoking, tobacco use remains the leading cause of premature death in the US. To ensure the sustained and impactful research dedicated to addressing tobacco use, rigorous inter-disciplinary mentoring programs are needed to prepare the next generation of researchers committed to patient-oriented research (POR) in this area. I have led a successful research program focused on testing methods to improve the use and effectiveness of treatments for tobacco for 21 years. For the first cycle of my K24, my primary mentorship goal was to train in mentorship and to formalize and enhance the mentoring activities that I had been engaged in from 2001-2017 into a structured, consistent, and comprehensive mentoring program in tobacco POR for students, fellows, and junior faculty. With K24 support over the past 4 years, I provided training to 21 new mentees, yielding 50 papers with mentees and 7 papers under review or in revision (>230 total by mentees) and 32 grants, including 5 Ks and 11 R01s, 3 as a New Investigator PI, compared to 25 mentees, 34 publications with mentees, and 2 Ks and 2 R01s in the preceding 17 years. For the first cycle of the K24, my primary research goal was to augment my tobacco POR by building expertise in implementation science through training and by pilot testing use of the nicotine metabolite ratio (NMR) – a genetically-informed biomarker of nicotine metabolism rate – for personalizing tobacco treatment as an implementation strategy to increase use of tobacco treatments. K24 support over the past 4 years, led to six new grants in tobacco and implementation science, 4 focused on testing the NMR in clinical practice: HIV care, primary care, and in-patients (R01 CA243914; U54 GM104941; P50 CA244690; R01 HG012670; SAP#4100083101; R01 DA056050). I leveraged this research in implementation science to augment my mentoring by serving as faculty on two national implementation science training programs – NCI's Training Institute for Dissemination and Implementation Research in Cancer and Washington University at St. Louis's Institute for Implementation Science Scholars – and by serving as co-chair for the Cancer Center Cessation Initiative's Implementation Science Working Group. In this renewal, I will: 1) sustain the mentoring program in tobacco and implementation science POR that I established with the first K24 cycle, using a structured, comprehensive, and individualized approach for an additional 15 mentees; and 2) augment our tobacco and implementation science POR by conducting a pilot study to develop messages informed by behavioral economics for HIV+ patients and infectious disease clinicians that are related to intention to refer for (clinician) or engage with (patient) tobacco use treatment and then test the impact of these messages integrated into the electronic health record as implementation science strategies to increase actual referral for and engagement in tobacco treatment in the HIV clinical setting. This renewal will ensure that I continue to provide the mentoring needed to build the next generation of scientists to address tobacco use and to continue to grow my impactful research in tobacco control and implementation science.