Panic-Relevant Sensations and Smoking Motivation

描述（由申请人提供）：吸烟是美国可预防死亡的主要原因，每年造成近44.3万人死亡。不幸的是，戒烟率仍然很低，复发很常见。越来越多的人一致认为，在帮助吸烟者戒烟方面，可能会发现有能力开发新的、专门的治疗方法，以满足吸烟者亚群的特殊需求，特别是那些复发风险较高的人。在这一领域，有一条很有前途的研究路线已经开始研究易恐慌和焦虑障碍人群，因为(a)吸烟率是非精神病人群的两倍，(b)有证据表明，恐慌发作和焦虑症状会严重影响戒烟的成功。研究努力的目的是确定将恐慌发作或焦虑状态与重新开始和维持吸烟行为联系起来的解释机制。焦虑敏感性（AS）是一种稳定的，但具有可塑性的，是一种基于认知的跨诊断结构，被描述为负面状态的“放大器”，如焦虑、疼痛或压力。研究表明，AS升高的吸烟者可能特别倾向于通过吸烟来缓解或避免痛苦的身体和情绪状态（如焦虑、惊恐发作）。然而，过去关于AS和吸烟的研究采用了描述性或相关性的方法；没有直接测量吸烟行为的地形；并且没有整合急性，恐慌相关状态在AS与吸烟动机（冲动，渴望和可观察到的吸烟行为）之间的关系中的作用。本研究旨在提供恐慌相关觉醒与吸烟动机之间的实证联系。假设实验室诱发的恐慌症状与吸烟动机的增加有因果关系，而AS会缓和这种影响。为了验证这些假设，将招募90名成年吸烟者（每天15支烟）参加一项实验室实验。

DESCRIPTION (provided by applicant): Cigarette smoking is the leading cause of preventable death in the United States, accounting for nearly 443,000 deaths annually. Unfortunately, smoking cessation rates remain low and relapse is common. There is growing consensus that significant strides in helping smokers quit will likely be found in the ability to develop novel, specialized treatments that target the particular needs of subgroups of smokers, especially those who are at higher risk for relapse. One promising line of research in this domain has begun to study panic-prone and anxiety disordered populations, given (a) rates of smoking are double to that of non-psychiatric populations and (b) evidence that panic attacks and anxiety symptoms can significantly impair quit success. Research efforts have aimed to identify explanatory mechanisms that link panic attacks or anxiety states with the re-initiation and maintenance of smoking behavior. Anxiety sensitivity (AS) is a stable, but malleable, is a cognitive-based transdiagnostic construct that has been described as an "amplifier" of negative states, such anxiety, pain, or stress. Research suggests that smokers with elevated AS may be especially prone to smoke to relieve or avoid distressing bodily and emotional states (e.g., anxiety, panic attacks). Yet, past work on AS and smoking has employed descriptive or correlational methodology; has not directly measured the topography of smoking behavior; and has not integrated the role of acute, panic-relevant states on the relation between AS and smoking motivation (urges, cravings and observable smoking behavior). The current study aims to provide the empirical link between panic-relevant arousal and smoking motivation. It is hypothesized that laboratory-induced panic symptoms will be causally related to an increase in smoking motivation and that AS will moderate this effect. To address these hypotheses, 90 adult smokers (e15 cigarettes per day) will be recruited to participate in a laboratory experiment. Participants will be randomly assigned to inhale a single vital capacity of 35% carbon dioxide [CO2]-enriched air mixture or compressed room air (control condition); this procedure is a safe and frequently used provocation method for panic symptoms. Post-challenge, smoking motivation will be evaluated by self-reported urges and behavioral indices of cravings (latency to smoking) and smoking topography (puff velocity and inter-puff interval - measured by mouthpiece-based, computerized system; Clinical Research Support System). The proposed project will identify factors that increase the risk of drug use and abuse, which addresses the focus of the National Institute of Drug Abuse (NIDA) prevention research goals. Ultimately, in accordance with NIDA's 2010 strategic plan, the proposed study will (1) identify the characteristics and patterns of drug abuse and (2) understand how factors influence the various risk factors for drug abuse. Finally, the award will aid in the ethical, methodological, and substantive training of a promising researcher to address the need for translational, innovative research on tobacco and emotional vulnerability.