Enhancing Tobacco Use Treatment for African American Light Smokers

非裔美国人吸烟较少，但与烟草相关的发病率和死亡率风险增加 每天吸烟的人比一般人多。在这个竞争的延续中，我们经验丰富， 多学科团队建议在以下坚实基础上进行合作研究： 美国城市非裔吸烟者的戒烟干预研究。我们之前的研究 证明了安非他酮在中度至重度吸烟者中戒烟的有效性， 健康教育咨询和限制轻度吸烟者使用尼古丁口香糖。我们计划扩大 这些努力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， 与药物活性和行为改变相关，目的是提高戒断结果。我们 具体目的是1）评价缓释安非他酮与健康 城市非裔美国人轻度吸烟者戒烟的教育（HE）咨询，2） 通过评价表型（3 HC/可替宁比值）和CYP 2A 6基因型表征CYP 2A 6活性，3） 通过评价表型和CYP 2B 6基因型表征CYP 2B 6活性，以评估尼古丁， 安非他酮代谢物水平，4）探索这些表型和基因型变量与 戒烟和对安非他酮的反应。这项随机、安慰剂对照研究将在 在密苏里州堪萨斯城的斯沃普百老汇健康中心，一家社区诊所。主要结局 在6个月时用唾液可替宁证实的7天点戒烟率。五百 四十名（每只手臂270名）非裔美国轻度吸烟者将被随机分配服用活性安非他酮， 健康教育（HE）咨询（Tx）条件或安慰剂和HE比较（C）条件。他酮 治疗（活性药物或安慰剂）将持续7周（戒烟日期前一周，戒烟日期后六周）。所有 参与者将获得六次HE课程。拟议的研究提供了一个独特的机会， 评价与吸毒和治疗结果有关的心理社会和生物机制。识别 与此相反，识别与治疗最有效的人相关的特征， 复吸风险对于促进非洲人有针对性的烟草使用治疗和健康促进至关重要 美国吸烟者

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.