Craving During Smoking Abstinence: Does it Abate or Incubate?

描述（由申请人提供）：复发仍然是药物滥用治疗中最持久和最重要的问题。多达90%的试图戒烟的吸烟者最终会复发，而吸烟者在急性戒断症状消退后仍有很高的复发风险。虽然复发最常发生在禁欲后不久，但最近的动物研究表明，对条件刺激的药物寻求反应在长达6个月的禁欲期内逐渐增加，这种现象称为“潜伏期”。虽然在动物实验室中，线索反应与操作性药物寻求反应密切相关，但人类的线索反应与药物摄入之间的关系尚未确定。我们建议通过研究人类吸烟者对吸烟线索的反应和戒烟后不同时间的复吸以及线索反应的变化是否与复吸时间的变化相关来研究这种潜伏现象是否发生在人类吸烟者中。该项目将在芝加哥大学进行，同时在巴尔的摩的国家药物滥用研究所校内研究方案进行一个类似的项目。本研究的目的是：1.评估吸烟者戒烟持续时间增加后吸烟提示反应的“潜伏期”。我们将研究戒烟者对吸烟线索的反应，作为戒烟7天、14天和35天后戒烟持续时间的函数。基于对实验室动物的研究，假设在更长时间的禁欲后，线索反应性将更大。2.评估戒烟持续时间增加后恢复吸烟倾向的“潜伏期”。在通过金钱激励维持戒烟7、14或35天后，将允许受试者恢复吸烟，并逐渐减少维持戒烟的金钱激励。我们初步假设，吸烟的潜伏期将减少，恢复吸烟的可能性将增加，经过较长时间的戒烟。这是一个转化项目，将实验室动物中的新发现应用于临床环境。这项研究使用了一种创新的方法来研究一种尚未在人类中表征的现象，但这可能与试图戒烟的吸毒者有临床相关性。该项目是芝加哥大学和NIDA校内研究计划的基础和临床科学家之间独特合作的结果。

DESCRIPTION (provided by applicant): Relapse remains the most persistent and significant problem in drug abuse treatment. As many as 90% of smokers who attempt to quit eventually relapse, and smokers remain at high risk for relapse well after their acute withdrawal symptoms have subsided. Although relapse most commonly occurs soon after abstinence, recent studies with animals indicate that drug-seeking responses to conditioned stimuli gradually increase in magnitude for as long as 6 months of abstinence, a phenomenon known as "incubation". While cue reactivity is closely linked to operant drug-seeking responses in the animal laboratory, the relationship between cue reactivity and drug-taking in humans has not been firmly established. We propose to investigate whether this incubation phenomenon occurs in human cigarette smokers by studying their reactivity to smoking cues and time to relapse to smoking after varying periods of abstinence and whether changes is cue reactivity are associated with changes in time to relapse. The project will be conducted at the University of Chicago, in parallel with a similar project at the National Institute on Drug Abuse Intramural Research Program in Baltimore. The goals of the study are: 1. To assess "incubation" of smoking-cue reactivity after increasing durations of abstinence in cigarette smokers. We will investigate the reactivity to smoking cues among abstinent cigarette smokers, as a function of duration of abstinence after 7, 14, and 35 days of abstinence. Based on the studies with laboratory animals, it is hypothesized that cue reactivity will be greater after longer periods of abstinence. 2. To assess "incubation" of the tendency to resume smoking after increasing durations of abstinence. After 7, 14 or 35 days of abstinence maintained with monetary incentives, subjects will be allowed to return to smoking, with gradually decreasing monetary incentives for maintaining abstinence. We tentatively hypothesize that the latency to smoking will decrease, and the likelihood of returning to smoking will increase, after longer periods of abstinence. This is a translational project that applies novel findings in laboratory animals to a clinical setting. The study uses an innovative procedure to investigate a phenomenon that has not yet been characterized in humans, but which may have clinical relevance for drug users attempting to abstain. The project is the result of a unique collaboration among basic and clinical scientists at the University of Chicago and the NIDA Intramural Research Program.