This is a revised application for a K23 Mentored Patient-Oriented Research Career Development Award. The purpose of the Award is to broaden the candidate's expertise in smoking cessation research by training in 1) adolescent smoking, and 2) human laboratory methodologies. The training and research plan focuses on stimulus control and cue reactivity in adolescent smoking - an area of research already established at the training site. Specific training objectives include 1) Gain expertise in cue reactivity research, 2) Gain expertise in adolescent nicotine dependence, its treatment, and methods of research, 3) Develop proficiency in statistical skills to be applied in clinical research, 4) Build and maintain understanding of responsible execution of patient-oriented research, and 5) Build and maintain state-of the-art treatment skills in smoking cessation that will guide future treatment outcome studies. These training objectives will be accomplished via coursework, collaboration in ongoing research, and mentoring. The overarching goal is to advance the candidate towards an independently funded research program that will enable him to develop innovative treatments for smoking cessation. The primary mentor, Dr. Himanshu Upadhyaya, has a track record of clinical research with adolescent smokers and cue reactivity. The training site has an established training program and strong track record in training drug abuse researchers. The independent study will test the degree of stimulus control among occasional (i.e., non-daily) and daily adolescent smokers. Indirect evidence suggests the smoking of occasional smokers is under greater stimulus control than daily smokers. Because alcohol cues are one of the most commonly cues associated with smoking among adolescent occasional smokers, the study will use cue reactivity to alcohol cues as a marker of stimulus control. The main hypotheses are 1) occasional adolescent smokers will demonstrate greater reactivity in response to alcohol-and cigarette-related cues than to neutral cues, 2) daily adolescent smokers will also demonstrate greater cue reactivity to alcohol and cigarette cues than neutral cues, 3) occasional smokers will demonstrate greater positive cue reactivity in response to alcohol cues than daily smokers, and 4) daily smokers will demonstrate greater cue reactivity in response to cigarette cues than occasional smokers. The study design calls for a 2 (daily vs. occasional smoker) x 3 (neutral vs. alcohol vs. cigarette cues) factorial study of cue-related craving. Alcohol and cigarette cues will consist of sensory cues (e.g., visual, olfactory), but will not include alcohol or tobacco ingestion. If these hypotheses are correct, this would suggest treatment and prevention efforts for adolescent occasional smokers need to especially address alcohol cues. More broadly, the proposed research will add to our understanding of how conditioning contributes to the development of nicotine dependence in adolescents.
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