Nicotine Dependence is a substantial problem for individuals with serious unique mental illness. The biopsychosocial problems of individuals with schizophrenia and the realities of the current mental health system have somehow shielded this population from the benefits of tobacco control efforts to better engage these heavy smokers into nicotine dependence treatment. This K23 Award is necessary to provide the candidate with the required time, resources, and additional training to further his patient oriented research interests in better understanding how to engage and treat nicotine dependence in smokers with schizophrenia. The proposed Primary Mentor (Douglas Ziedonis) and the UMDNJ/Rutgers environment offers much to help the applicant achieve his goal of becoming an independent researcher. The research plan includes two studies that seek to further evaluate why so few smokers with schizophrenia quit compared to the general population and to develop interventions to engage this population into tobacco dependence treatment. The first study is a Patient-Oriented Laboratory Study that will a) Compare levels of task persistence, cognition, and motivation in smokers with and without schizophrenia, and b) Evaluate task persistence as a partial mediator of psychiatric status and nicotine dependence treatment outcome. An additional reason smokers with schizophrenia may be less likely to quit smoking may be related to their motivation to make a quit attempt. The second study is a Stage 1 a/b Behavioral Therapy Development Study that will build on the candidate's prior research on enhancing motivation to seek nicotine dependence treatment. The primary aims include a) Further develop a computerized personal feedback assessment, b) Further develop an impact scale of feedback items, c) Create a therapy manual, adherence scale, training program, and randomized study to determine the appropriate effect size with which to power a future Stage II study. The training plan aims to complement the research plan and advance the candidate's professional skills. The plan will include important hands-on learning experiences, workshops, class work, attendance at national scientific conferences, and strong mentoring relationships.
