Acute and intermediate effects of smoking cessation on erectile functioning

烟草使用是当今世界上唯一最可预防的疾病和死亡原因，并导致许多疾病，包括许多类型的癌症，心血管疾病和呼吸系统疾病。仅在美国，每五个死亡中就有一个与吸烟有关，这意味着每年与健康有关的经济损失估计为1570亿美元。据报告，性功能受损也是长期吸烟的后遗症。大量文献表明，吸烟是导致男性勃起功能障碍的独立危险因素，慢性吸烟者报告勃起功能障碍的可能性约为非吸烟者的1.5至2倍。这项研究的主要目的是提供第一个实证调查的急性和中间的影响戒烟的生理和主观措施的性功能的男性谁正在经历勃起障碍。吸烟受试者（N=100）将接受4次测试;在基线时随意吸烟，尼古丁透皮贴剂治疗（21 mg）第一周期间，贴剂停用后24小时和贴剂停用后8周。受试者将以递减方式使用尼古丁贴片8周（每天21 mg，持续4周;每天14 mg，持续2周;每天7 mg，持续2周）。在每次访视期间，将通过严格的心理生理学技术（阴茎体积描记术以测量勃起能力）和自我报告测量（性唤起、性欲和性满意度）评估性功能。在每次访视期间，将额外评估性激素（睾酮）和体内尼古丁浓度水平。将吸烟者的性功能与匹配的非吸烟对照组（N=30）进行比较，以确定吸烟男性在性功能的生物学、生理学和主观方面是否恢复了与非吸烟者相似的特征。本研究采用了转化研究的方法，希望这些研究结果可能有潜力促进针对男性吸烟的预防和戒烟的计划和干预措施。因此，我们相信，本研究的目的将有助于进一步的使命的国家药物滥用研究所（NIDA）的行为和综合治疗分支（BITB），在临床神经科学和行为研究（DCNBR）的部门。

DESCRIPTION (provided by applicant): Tobacco use constitutes the single most preventable cause of disease and death in the world today and is responsible for introducing a number of diseases including many types of cancer, cardiovascular diseases, and respiratory diseases. In the United States alone one in every five deaths is smoking related, which translates to an estimated $157 billion in health-related economic losses each year. Impairment in sexual functioning has also been reported as sequelae of long-term tobacco intake. Extensive literature indicates that cigarette smoking is an independent risk factor for introducing erectile impairment in men, and that chronic smokers are approximately 1.5 to 2 times as likely as nonsmokers to report erectile dysfunction. The primary aim of the study is to provide the first empirical investigation of both the acute and intermediate effects of smoking cessation on physiological and subjective measures of sexual function in men who are experiencing erectile impairments. Smoking participants (N=100) will be tested 4 times; at baseline while smoking ad lib, during the first week of nicotine transdermal patch treatment (21 mg), 24 hours after patch cessation, and 8 weeks after patch cessation. Participants will use the nicotine patch for 8 weeks in a step-down fashion (21 mg daily for 4 weeks; 14 mg daily for 2 weeks; 7 mg daily for 2 weeks). During each visit, sexual functioning will be assessed via rigorous psycho-physiological techniques (penile plethysmography to measure erectile capacity) and by self-report measures (sexual arousal, sexual desire, and sexual satisfaction). Sex hormones (testosterone) and in vivo nicotine concentration levels will additionally be assessed during each visit. The sexual functioning of smokers will be compared to matched, nonsmoking controls (N=30) in order to ascertain whether men who smoke regain a similar profile to nonsmokers with respect to biological, physiological, and subjective aspects of sexual function. The present study adopts a translational research approach in the hope that these findings may have the potential for facilitating programs and interventions targeting the prevention and cessation of cigarette smoking in men. We therefore believe that the aims of the present study will help further the mission of the National Institute for Drug Abuse's (NIDA) Behavioral and Integrative Treatment Branch (BITB), within the Division of Clinical Neuroscience and Behavioral Research (DCNBR).