Enhancing Tobacco Use Treatment for African American Light Smokers

尽管吸烟减少，但非裔美国人患烟草相关疾病和死亡的风险增加 每天抽的香烟比一般人还多。在这场竞争的延续中，我们经验丰富的 多学科团队建议在以下强大基础上进行协作研究 城市非裔美国吸烟者戒烟干预研究。我们之前的研究 证明安非他酮对中到重度吸烟者戒烟有效， 健康教育、咨询和对轻度吸烟者使用尼古丁口香糖的限制。我们计划延长 这些努力旨在进一步评估吸烟行为和生物行为干预，并探索影响吸烟的因素 与药物活动和行为改变有关，目的是提高戒毒效果。我们的 具体目标是：1)评估安非他酮缓释片与健康的联合疗效 城市非裔美国轻吸烟者戒烟教育咨询，2) 通过评估表型(3HC/可替宁比率)和CYP2A6基因来表征CYP2A6的活性，3) 通过评估表型和CYP2B6基因以评估尼古丁和 安非他酮代谢物水平，4)探索这些表型和基因变量与 戒烟和对安非他酮的反应。这项随机的、安慰剂对照的研究将在 密苏里州堪萨斯城的斯沃普公园路健康中心是一家社区诊所。主要结果是 6个月时戒烟的7天时点患病率是否与唾液可替宁一致。五百 40名(每只手臂270名)非裔美国人轻吸烟者将被随机分配到一种活性安非他酮和 健康教育(HE)咨询(TX)条件或安慰剂和HE比较(C)条件。安非他酮 治疗(主动或安慰剂)将持续7周(戒烟前一周，戒烟后六周)。全 参与者将被提供六次高等教育课程。拟议的研究提供了一个独特的机会来 评估与药物使用和治疗结果有关的心理社会和生物机制。识别 个人谁的治疗是最有效的，相反，识别与 复发风险将是推动非洲有针对性的烟草使用治疗和健康促进的关键 美国烟民。

African Americans are at increased risk for tobacco related morbidity and mortality despite smoking fewer cigarettes per day than the general population. Within this competing continuation, our experienced, multidisciplinary team proposes to conduct collaborative research building upon a strong foundation of smoking cessation intervention studies among urban African American smokers. Our previous research demonstrated efficacy of bupropion for smoking cessation among moderate to heavy smokers, efficacy of health education counseling and limitations in nicotine gum use among light smokers. We plan to extend these efforts to further evaluate smoking behavior and biobehavioral interventions and to explorefactors associated with drug activity and behavior change with the goal of enhancing abstinence outcomes. Our specific objectives are to 1) evaluate the efficacy of sustained release bupropion in combination with health education (HE) counseling for smoking cessationamong urban African American light smokers, 2) characterize CYP2A6 activity by evaluating phenotype (3HC/cotinine ratio ) and CYP2A6 genotype, 3) characterize CYP2B6 activity by evaluating phenotype and CYP2B6 genotype to assess nicotine and bupropion metabolite levels, 4) explore associations of these phenotypic and genotypic variables with smoking cessation and response to bupropion. This randomized, placebo-controlled study will be conducted at a community-based clinic, Swope Parkway Health Center in Kansas City, Missouri. The primary outcome is 7-day point prevalence smoking abstinence at 6 months confirmed with salivary cotinine. Five hundred forty (270 in each arm) African American light smokers will be randomly assigned to an active bupropion and health education (HE) counseling (Tx) condition or to a placebo and HE comparison (C) condition. Bupropion treatment (active or placebo) will last for 7 weeks (one week prior to quit date, six weeks post quit date). All participants will be offered six HE sessions. The proposed research provides a unique opportunity to evaluate psychosocial and biological mechanisms related to drug use and treatment outcomes. Identifying ndividuals for whom treatments are most effective and, in contrast, identifying characteristics related to relapse risk will be critical to advancing tailored tobacco use treatment and health promotion for African American smokers.