Smoking Cessation Clinical Trial
Official title:
Physiological, Cognitive and Cerebral Activity Changes as a Function of Cigarette Smoking (With or Without Nicotine) and Tobacco Abstinence
Background:
- Denicotinized cigarettes are similar to commercial cigarettes but contain and deliver
virtually no nicotine. Denicotinized cigarettes are used as a control condition in
smoking research, as a substitute treatment for nicotine dependence, and as a strategy
to reduce incidence of nicotine addiction. However, the symptoms of nicotine withdrawal
and craving for cigarettes must be minimized to ensure that smokers will continue to use
denicotinized cigarettes instead of their preferred cigarettes.
- Although research has shown that smokers preferred cigarettes that delivered nicotine,
subjective measures of tobacco craving and withdrawal were similar after standard and
denicotinized cigarettes. This suggests that the process of smoking and non-nicotine
components of tobacco smoke mediate some of the effects of cigarette smoking. More
research is needed on the comparative physical and mental effects of regular cigarettes
and denicotinized cigarettes.
Objectives:
- To compare the effects of complete abstinence or smoking denicotinized cigarettes with
smoking nicotinized cigarettes on the following measures: (1) withdrawal symptoms and quality
of sleep, (2) hormonal responses, (3) mood and cognitive performance, and (4) functional
brain activity.
Eligibility:
- Men between 18 and 50 years of age who are either current smokers (at least 15 cigarettes
per day for at least 2 years) or nonsmoking volunteers.
Design:
- Participants will be divided into four groups: (1) nonsmokers, (2) smokers who receive
nicotinized cigarettes, (3) smokers who receive denicotinized cigarettes, and (4)
smokers who will abstain from cigarettes.
- The study will last 16 days. Smokers will have 14 visits to the clinical center;
nonsmokers will have 6 visits. From Day 6 to Day 14, current smokers will follow the
smoking regimen assigned by the researchers (not smoking, smoking denicotinized
cigarettes, or smoking nicotinized cigarettes).
- Nonsmokers will have one day of training on the memory and thinking tasks that will be
performed in the functional magnetic resonance imaging (fMRI) scanner, and will have 5
additional days of two fMRI scans per day (total of 10 fMRI scans).
- Current smokers will have 2 days of training on the memory and thinking tasks that will
be performed in the fMRI scanner, physical assessments on Day 3 and Day 6, and 5 days of
two fMRI scans per day (total of 10 fMRI scans).
- Participants in the complete abstinence group will be asked to resume smoking after the
abstinence period and the denicotinized cigarettes group will resume nicotinized
cigarettes on day 14. Participants can decline to resume smoking, and if desired they
will be referred for smoking cessation treatment.
Objective:
To compare the effects of complete abstinence or smoking denicotinized research cigarettes to
smoking ad libitum nicotinized research cigarettes on the following measures: withdrawal
symptoms and quality of sleep; MAO-A and MAO-B activities; hormonal responses (HPA, HPT);
mood, cognitive and psychometric performance; functional brain activity, and physiological
responses.
Study Population:
Participants are 125 men who are at least 18 years old, report smoking at least 15 cigarettes
per day, have not used any illicit drug except marijuana in the past year, have no history of
drug or alcohol dependence, and have already experienced tobacco withdrawal symptoms when
they had no access to cigarettes.
Design:
Smokers will be randomized into one of the following 3 groups: a) complete tobacco abstinence
for 8 days; b) denicotinized research cigarettes for 8 days, or c) control group smoking
nicotinized research cigarettes during the entire study (16 days). Because there are few
studies comparing functional brain activity in smokers and nonsmokers, a group of nonsmokers
will serve as a control group for the brain imaging studies.
Outcome Measures:
Withdrawal symptoms, mood, quality of sleep, cognitive performance, temperature, blood
pressure and heart rate, MAO-A parameters: plasma DHPG (dihydroxyphenylglycol), HVA
(homovanillic acid), 5HIAA (5-hydroxyindolacetic acid); MAO-B parameters: urinary excretion
of phenylethylamine, platelet MAO-B activity; hormonal parameters: serum ACTH, cortisol, TSH,
thyroxine, triiodothyronine; EEG; cigarette liking; expired air CO; and functional brain
activity.
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