Stimulus Control and Trajectories of Adolescent Smoking

描述（由申请人提供）：这是K23指导患者导向研究职业发展奖的修订申请。该奖项的目的是通过1)青少年吸烟和2)人体实验室方法方面的培训，拓宽候选人在戒烟研究方面的专业知识。培训和研究计划的重点是青少年吸烟的刺激控制和暗示反应，这是一个在培训地点已经建立的研究领域。具体的培训目标包括：1)获得线索反应性研究方面的专业知识；2)获得青少年尼古丁依赖及其治疗和研究方法方面的专业知识；3)熟练掌握应用于临床研究的统计技能；4)建立并保持对以患者为导向的研究的负责任执行的理解；5)建立并保持戒烟方面的最新治疗技能，这将指导未来的治疗结果研究。这些培训目标将通过课程作业、正在进行的研究中的合作和指导来完成。总体目标是推动候选人进入一个独立资助的研究项目，使他能够开发出戒烟的创新治疗方法。主要导师希曼舒·乌帕德哈亚博士（Himanshu Upadhyaya）在青少年吸烟者和线索反应的临床研究方面有着良好的记录。该培训中心有一个成熟的培训项目，在培训药物滥用研究人员方面有着良好的记录。这项独立研究将测试偶尔（即非每天）和每天吸烟的青少年的刺激控制程度。间接证据表明，偶尔吸烟的人比每天吸烟的人受到更大的刺激控制。因为在偶尔吸烟的青少年中，酒精是与吸烟有关的最常见的线索之一，所以该研究将使用线索对酒精线索的反应作为刺激控制的标志。主要假设是：1)偶尔吸烟的青少年对酒精和香烟相关线索的反应比中性线索更强烈；2)每天吸烟的青少年对酒精和香烟线索的反应也比中性线索更强烈；3)偶尔吸烟的青少年对酒精线索的反应比每天吸烟的青少年更积极；4)与偶尔吸烟者相比，每天吸烟者对香烟线索的反应更强烈。研究设计要求对提示相关的渴望进行2（每日吸烟vs偶尔吸烟）× 3（中性提示vs酒精提示vs香烟提示）的析因研究。酒精和香烟线索将包括感官线索（如视觉、嗅觉），但不包括酒精或烟草摄入。如果这些假设是正确的，这将表明治疗和预防青少年偶尔吸烟者需要特别注意酒精线索。更广泛地说，拟议的研究将增加我们对条件作用如何促进青少年尼古丁依赖发展的理解。

DESCRIPTION (provided by applicant): This is a revised application for a K23 Mentored Patient-Oriented Research Career Development Award. The purpose of the Award is to broaden the candidate's expertise in smoking cessation research by training in 1) adolescent smoking, and 2) human laboratory methodologies. The training and research plan focuses on stimulus control and cue reactivity in adolescent smoking - an area of research already established at the training site. Specific training objectives include 1) Gain expertise in cue reactivity research, 2) Gain expertise in adolescent nicotine dependence, its treatment, and methods of research, 3) Develop proficiency in statistical skills to be applied in clinical research, 4) Build and maintain understanding of responsible execution of patient-oriented research, and 5) Build and maintain state-of the-art treatment skills in smoking cessation that will guide future treatment outcome studies. These training objectives will be accomplished via coursework, collaboration in ongoing research, and mentoring. The overarching goal is to advance the candidate towards an independently funded research program that will enable him to develop innovative treatments for smoking cessation. The primary mentor, Dr. Himanshu Upadhyaya, has a track record of clinical research with adolescent smokers and cue reactivity. The training site has an established training program and strong track record in training drug abuse researchers. The independent study will test the degree of stimulus control among occasional (i.e., non-daily) and daily adolescent smokers. Indirect evidence suggests the smoking of occasional smokers is under greater stimulus control than daily smokers. Because alcohol cues are one of the most commonly cues associated with smoking among adolescent occasional smokers, the study will use cue reactivity to alcohol cues as a marker of stimulus control. The main hypotheses are 1) occasional adolescent smokers will demonstrate greater reactivity in response to alcohol-and cigarette-related cues than to neutral cues, 2) daily adolescent smokers will also demonstrate greater cue reactivity to alcohol and cigarette cues than neutral cues, 3) occasional smokers will demonstrate greater positive cue reactivity in response to alcohol cues than daily smokers, and 4) daily smokers will demonstrate greater cue reactivity in response to cigarette cues than occasional smokers. The study design calls for a 2 (daily vs. occasional smoker) x 3 (neutral vs. alcohol vs. cigarette cues) factorial study of cue-related craving. Alcohol and cigarette cues will consist of sensory cues (e.g., visual, olfactory), but will not include alcohol or tobacco ingestion. If these hypotheses are correct, this would suggest treatment and prevention efforts for adolescent occasional smokers need to especially address alcohol cues. More broadly, the proposed research will add to our understanding of how conditioning contributes to the development of nicotine dependence in adolescents.