Nicotine dependence is the most prevalent substance abuse disorder among psychiatric patients, a group that accounts for 44% of the U.S. tobacco market. While numerous trials have established the effectiveness of smoking cessation interventions for hospitalized medical patients, psychiatric inpatients have largely been excluded. The objective of this proposal is to support the candidate's development of skills to perform patient-oriented research in the area of tobacco dependence treatment with comorbid smokers in new settings. The career plan includes training in clinical trials, cost-effectiveness, and psychopharmacology. The UCSF Department of Psychiatry and the NIDA-funded P50 San Francisco Treatment Center provide an exceptional environment for developing research investigators. The primary mentor, Dr. Sharon Hall, is a leading expert in the treatment of nicotine dependence and other drugs of abuse. Her extensive research background includes treatment of comorbid smokers in psychiatric settings. The primary specific aim of the research plan is to test in a randomized clinical trial (N=300) a series of hypotheses concerning the efficacy of an extended expert-system intervention plus nicotine replacement therapy (NRT) for treating tobacco dependence among patients hospitalized on a smoke-free psychiatric unit. It is hypothesized that the intervention will be more effective than the enhanced standard care control condition (on-unit NRT with self-help brochure) in producing biochemically verified abstinence from cigarettes at 3-, 6-, 12-, and 18-months follow up. Additionally, intervention participants will exhibit greater stage progression, commitment to abstinence, and delay in relapse to smoking following hospital discharge, factors predictive of future success with quitting smoking. Smoking cessation treatments have been shown to be highly cost-effective with the general population of smokers, and cost is likely to be a consideration in efforts to incorporate additional services into an inpatient psychiatric setting. Therefore, a secondary specific aim is to model the cost-effectiveness of the smoking cessation intervention. Intervention efficacy will be examined in a university-based psychiatric inpatient unit. A smaller pilot study (N=48) will examine translation of the intervention to a county hospital serving a more diversified patient population. Findings will be used in submission of an R01 application to conduct a multisite randomized trial.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23DA018691-01
Application #
6850325
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Grossman, Debra
Project Start
2005-05-25
Project End
2010-04-30
Budget Start
2005-05-25
Budget End
2006-04-30
Support Year
1
Fiscal Year
2005
Total Cost
$138,374
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Das, Smita; Hickman, Norval J; Prochaska, Judith J (2017) Treating Smoking in Adults With Co-occurring Acute Psychiatric and Addictive Disorders. J Addict Med 11:273-279
Thrul, Johannes; Belohlavek, Alina; Hambrick, D'Arius et al. (2017) Conducting online focus groups on Facebook to inform health behavior change interventions: Two case studies and lessons learned. Internet Interv 9:106-111
Hall, Sharon M; Shi, Yanling; Humfleet, Gary L et al. (2015) Smoking cessation abstinence goal in treatment-seeking smokers. Addict Behav 42:148-53
Ramo, Danielle E; Thrul, Johannes; Chavez, Kathryn et al. (2015) Feasibility and Quit Rates of the Tobacco Status Project: A Facebook Smoking Cessation Intervention for Young Adults. J Med Internet Res 17:e291
Hickman 3rd, Norval J; Delucchi, Kevin L; Prochaska, Judith J (2015) Treating Tobacco Dependence at the Intersection of Diversity, Poverty, and Mental Illness: A Randomized Feasibility and Replication Trial. Nicotine Tob Res 17:1012-21
Prochaska, Judith J; Fromont, Sebastien C; Ramo, Danielle E et al. (2015) Gender differences in a randomized controlled trial treating tobacco use among adolescents and young adults with mental health concerns. Nicotine Tob Res 17:479-85
Barnett, Paul G; Wong, Wynnie; Jeffers, Abra et al. (2015) Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial. J Clin Psychiatry 76:e1285-91
Brown-Johnson, Cati G; Cataldo, Janine K; Orozco, Nicholas et al. (2015) Validity and reliability of the Internalized Stigma of Smoking Inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses. Am J Addict 24:410-8
Young-Wolff, Kelly C; Hickman 3rd, Norval J; Kim, Romina et al. (2015) Correlates and prevalence of menthol cigarette use among adults with serious mental illness. Nicotine Tob Res 17:285-91
Ramo, Danielle E; Young-Wolff, Kelly C; Prochaska, Judith J (2015) Prevalence and correlates of electronic-cigarette use in young adults: findings from three studies over five years. Addict Behav 41:142-7

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