Nicotine Dependence Clinical Trial
Official title:
Clinical Relevance of Stress Neuroadaptation in Tobacco Dependence
The objective of the current study is to evaluate the validity of the No Shock, Predictable Shock, Unpredictable Shock (NPU) stressor task for use as a surrogate endpoint to predict short-term clinical outcomes among smokers during a smoking cessation attempt.
Smokers recruited for this study are randomly assigned at a screening session to complete the
NPU stressor task pre-quit or post-quit (i.e., nicotine deprived or non-deprived).
Participants are also randomized to receive either placebo or active combination nicotine
replacement therapy (NRT; patches and lozenges) for a two week smoking cessation period. The
NPU stressor task measures stressor reactivity to predictable and unpredictable stressors
(i.e., electric shock). Startle potentiation during predictable and unpredictable stressors
(relative to no-shock) provides the primary measures of stressor reactivity in this task.
Predictable and unpredictable startle potentiation are used to calculate overall stressor
reactivity and selective unpredictable stressor reactivity. Further detail on these
reactivity measures is provided in the Independent Variables section. Detail on the
quantification of startle potentiation is provided at the end of this registration.
Smokers provide three weeks (1 week pre-quit, 2 weeks post-quit) of brief 4x daily, real-time
web-survey reports of recent cigarette use, NRT use, and other measures not relevant to this
study's purpose on the participants' smartphones. At two weeks post-quit, smokers are
scheduled for a laboratory visit where participants provide an additional report via staff
interview of any smoking during the two-week smoking cessation period.
The stressor reactivity measures from the NPU task will be tested as predictors of clinical
outcome (i.e., continuous abstinence during the two-week cessation period) to evaluate the
validity of each as surrogate endpoints for use in research on stress mechanisms in smoking
relapse. Deprivation status at the time of the NPU stressor task will be examined as a
moderator of the effect of stressor reactivity to determine if the surrogate endpoints
predict clinical outcome generally or only as deprivation increases.
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