The exclusion of individuals with bipolar disorder from smoking cessation treatment research to date is disconcerting, as the prevalence of smoking in this group is roughly double that of the general population and the efficacy and safety of current treatment approaches for bipolar smokers is essentially unknown. This K23 Mentored Patient-Oriented Research Career Development Award proposal requests a 5-year period of support for Dr.
J aim ee Heffner to complete a focused program of training and research involving combined pharmacological and behavioral smoking cessation interventions for individuals with bipolar disorder. The proposed career development activities will facilitate Dr. Heffner's long-term career goal of identifying efficacious smoking cessation interventions for individuals with psychiatric disorders, with an emphasis on bipolar disorders and substance use disorders. Dr. Robert Anthenelli and Dr. Stephen Strakowski, the applicant's co-mentors and established investigators in the areas of smoking cessation and bipolar disorder treatment, respectively, will oversee completion of the applicant's career development goals. The University of Cincinnati College of Medicine will provide a strong infrastructure to complete both the training and research plans of the award. The proposed research plan includes developing and pilot testing a novel behavioral smoking cessation intervention, the Targeted Intervention for Bipolar Smokers (TIBS). TIBS will be developed and pilot-tested in two phases, consistent with Stage Ia and Stage Ib of the Stage Model of Behavioral Therapies research (Rounsaville, Carroll, &Onken, 2001). The first phase will involve developing a treatment manual, treatment integrity measures, and therapist training materials, as well as pre-pilot testing (n=10). The second phase will be a 12-week pilot trial in which all participants will be randomized to receive either TIBS (n=20) or a control treatment equated for contact time (n=20). All participants will receive 8 weeks of open- label transdermal nicotine replacement therapy. The results of this research will lay the groundwork for an R01 application to fund a larger-scale efficacy trial as well as advancing understanding of the complex relationship between psychiatric symptoms and smoking.

Public Health Relevance

Individuals with psychiatric disorders smoke almost half of the cigarettes sold in the U.S. and die up to three decades earlier than individuals who do not have psychiatric disorders. This award will allow the applicant to develop expertise in smoking cessation research for individuals with bipolar disorder, a critically underserved group with a high prevalence of smoking and low rate of successful quitting.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Grossman, Debra
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Fred Hutchinson Cancer Research Center
United States
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Heffner, Jaimee L; Vilardaga, Roger; Mercer, Laina D et al. (2015) Feature-level analysis of a novel smartphone application for smoking cessation. Am J Drug Alcohol Abuse 41:68-73
Bricker, Jonathan B; Mull, Kristin E; Kientz, Julie A et al. (2014) Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug Alcohol Depend 143:87-94
Vilardaga, Roger; Heffner, Jaimee L; Mercer, Laina D et al. (2014) Do counselor techniques predict quitting during smoking cessation treatment? A component analysis of telephone-delivered Acceptance and Commitment Therapy. Behav Res Ther 61:89-95
Bricker, Jonathan B; Bush, Terry; Zbikowski, Susan M et al. (2014) Randomized trial of telephone-delivered acceptance and commitment therapy versus cognitive behavioral therapy for smoking cessation: a pilot study. Nicotine Tob Res 16:1446-54
Heffner, Jaimee L; Lewis, Daniel F; Winhusen, Theresa M (2013) Osmotic release oral system methylphenidate prevents weight gain during a smoking-cessation attempt in adults with ADHD. Nicotine Tob Res 15:583-7
Heffner, Jaimee L; Anthenelli, Robert M; DelBello, Melissa P et al. (2013) Mood management and nicotine patch for smoking cessation in adults with bipolar disorder. Nicotine Tob Res 15:1805-6
Heffner, Jaimee L; Lewis, Daniel F; Winhusen, Theresa M (2013) Preliminary evidence that adherence to counseling mediates the effects of pretreatment self-efficacy and motivation on outcome of a cessation attempt in smokers with ADHD. Nicotine Tob Res 15:393-400
Heffner, Jaimee L; Wyszynski, Christopher M; Comstock, Bryan et al. (2013) Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 38:2473-6
Bricker, Jonathan; Wyszynski, Christopher; Comstock, Bryan et al. (2013) Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine Tob Res 15:1756-64
Heffner, Jaimee L; Anthenelli, Robert M; Adler, Caleb M et al. (2013) Prevalence and correlates of heavy smoking and nicotine dependence in adolescents with bipolar and cannabis use disorders. Psychiatry Res 210:857-62

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