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
Mcnamara-Spitznas, Cecilia M
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University of Cincinnati
Schools of Medicine
United States
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Heffner, Jaimee L; Watson, Noreen L; McClure, Jennifer B et al. (2018) ""I Smoke Like This to Suppress These Issues That Are Flaws of My Character"": Challenges and Facilitators of Cessation Among Smokers With Bipolar Disorder. J Dual Diagn 14:32-39
Heffner, Jaimee L; McClure, Jennifer B; Mull, Kristin E et al. (2015) Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: preliminary evaluation of in-person and telephone-delivered treatment. Bipolar Disord 17:560-6
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
Zeng, Emily Y; Vilardaga, Roger; Heffner, Jaimee L et al. (2015) Predictors of Utilization of a Novel Smoking Cessation Smartphone App. Telemed J E Health 21:998-1004
Jones, Helen A; Heffner, Jaimee L; Mercer, Laina et al. (2015) Web-based acceptance and commitment therapy smoking cessation treatment for smokers with depressive symptoms. J Dual Diagn 11:56-62
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
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
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
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

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