Enhancing Tobacco Use Treatment for African American Light Smokers

加强对非裔美国轻度吸烟者的烟草使用治疗

基本信息

批准号：
7283578
负责人：
LISA SANDERSON COX
金额：
$ 57.77万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-08-21 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7283578
关键词：
Abstinence African American Biological Blood Bupropion Bupropion/Nicotine CYP2B6 gene Characteristics Cigarette Cities Clinic Collaborations Communities Condition Cotinine Counseling Daily Dose Double-Blind Method Drug usage Foundations General Population Genetic Genetic Polymorphism Genetic Variation Genotype Goals Health Health Promotion Health education Individual Institution Intervention Intervention Studies Investigation Kansas Light Measurable Measures Metabolism Methods Missouri Morbidity - disease rate Nicotine Outcome Parents Participant Pattern Pharmaceutical Preparations Pharmacotherapy Phenotype Placebo Control Placebos Prevalence Prostaglandin-Endoperoxide Synthase Psychosocial Factor Randomized Range Rate Relapse Relative (related person)Research Research Personnel Risk Salivary Sampling Serum Smoke Smoker Smoking Smoking Behavior Smoking Cessation Intervention Smoking History Standards of Weights and Measures Tablets Tobacco Tobacco use Treatment outcome United States National Institutes of Health Upper arm Variant Week base behavior change biobehavior cyclooxygenase 1 cytochrome P-450 CYP2A6 (human)day design drug metabolism experience genetic variant hydroxycotinine mortality multidisciplinary nicotine gum nicotine replacement programs psychosocial randomized placebo controlled trial response smoking cessation smoking prevalence

项目摘要

DESCRIPTION (provided by applicant): 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 explore factors 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 cessation among 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 individuals 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.

描述（由申请人提供）：尽管非裔美国人每天吸烟的数量比一般人群少，但与烟草相关的发病率和死亡率的风险却增加。在这一竞争性的延续中，我们经验丰富的多学科团队建议在城市非裔美国吸烟者戒烟干预研究的坚实基础上开展合作研究。我们之前的研究证明了安非他酮对中度至重度吸烟者戒烟的功效、健康教育咨询的功效以及轻度吸烟者使用尼古丁口香糖的局限性。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措施，并探索与药物活性和行为改变相关的因素，以提高戒烟效果。我们的具体目标是 1) 评估缓释安非他酮与健康教育 (HE) 咨询相结合对城市非裔美国轻度吸烟者戒烟的功效，2) 通过评估表型（3HC/可替宁比率）和 CYP2A6 基因型来表征 CYP2A6 活性, 3) 通过评估表型和 CYP2B6 基因型来表征 CYP2B6 活性，以评估尼古丁和安非他酮代谢物水平，4) 探讨这些表型和基因型变量与戒烟和对安非他酮反应的关联。这项随机、安慰剂对照研究将在密苏里州堪萨斯城的一家社区诊所 Swope Parkway 健康中心进行。主要结局是用唾液可替宁证实的 6 个月戒烟 7 天点患病率。 540 名（每组 270 名）非裔美国轻度吸烟者将被随机分配到活性安非他酮和健康教育 (HE) 咨询 (Tx) 组或安慰剂和 HE 比较 (C) 组。安非他酮治疗（活性药物或安慰剂）将持续 7 周（戒烟日期前 1 周，戒烟日期后 6 周）。所有参与者将接受六次高等教育课程。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相关的心理社会和生物机制。确定治疗最有效的个体，相反，确定与复吸风险相关的特征对于推进针对非裔美国吸烟者的定制烟草使用治疗和健康促进至关重要。