The overall goal of the project is to significantly improve treatment of nicotine dependence. The health implications are considerable as smoking is a major cause of disease and death. Identifying individual needs in treatment and better defining mechanism in addiction (withdrawal; craving) can contribute to understanding other addictive behaviors. The specific aims of the project are: a) to test preference as a new approach for matching smokers to treatment; b) to better understand the relative role of various reinforcers in smoking and treatment. Two studies are designed to test these aims: the first is a crossover trial testing preference and withdrawal among 3 "acute" nicotine systems (nasal spray, nicotine inhaler, a new nicotine sublingual tablet); the second is a crossover trial of 4 combination treatments -3 combining a patch with each of the 3 "acute" systems and a double-active patch condition. Combining treatments (Study 2) can provide steady nicotine levels (patch) with an immediate means (acute) for handling cravings or crises; this bypasses the individual limitations of the patch (passive, slow) and of the acute systems (insufficient use). With excessive drop- out and relapse-producing slips plaguing current treatment, our aim is to determine what treatments individuals will use in practice and how different reinforcers (sensory, ritual, pharmacologic) contribute to compliance. We posit that knowledge of such biases will be essential for treatment matching and for proper use of any treatment. In essence, matching smokers to preferred treatments should greatly enhance success rates along with considerations of dose and pre-existing conditions. Several new scales will be tested: one which assesses withdrawal via anchored responding and a set of scales for testing preference with an ultimate aim of developing a tool for easily matching smokers to therapy.
NIH ExPorter
NIH ExPorter