There is considerable evidence that behavioral factors such as smoking, drug-taking and psychological stress have an important impact on the risk of cardiovascular and immune-related diseases, including infectious and neoplastic disorders. Recent findings also suggest that these factors can promote viral infections and accelerate the development of some AlDS-related infections in HIV seropositive individuals. Given the potential health impact of these risk factors in both normal and at-risk (e.g., HIV positive) populations, there is need for more basic research on the mechanisms mediating their cardiovascular and immune actions. Moreover, these factors rarely occur individually outside of the laboratory, and a more realistic laboratory model should include their convergent, in addition to their isolated effects. Finally, considerably more research has been devoted to the effects of these variables in men and more information is needed on their consequences in women. Our research team has had considerable experience in studying the endocrine, cardiovascular and immunological effects of smoking and stress in men and women and the endocrine and immunological effects of nicotine in laboratory animals. On the basis of our research, and the findings of others, we propose that smoking and stress are convergent risk factors for cardiovascular and immune-related disease and that their convergent effects may be mediated by acute activation of the sympathetic nervous system. We now propose to extend our research to study the convergent effects in women of two of these factors, psychological stress and smoking. Specifically, we will determine: 1) how the effects of smoking and acute stress on the immune and sympathetic nervous systems converge in women and 2) how the convergent effects of smoking and stress in women are altered by smoking cessation. The first goal will be achieved by comparing the effects of acute laboratory stress on smokers, with and without concurrent smoking, to the effects of stress in non-smokers. The second will be approached by using an already planned and funded smoking treatment program to assess baseline and stress-induced changes in the function of the SNS and immune systems which accompany cessation of smoking in women.
