Over 75% of patients with schizophrenia are nicotine dependent, and most of them die of smoking related illnesses. Few are offered nicotine dependence treatment in primary care or mental health settings. Unfortunately there have been few clinical treatment studies, and there continues to be a great need to develop, test, and disseminate behavioral therapy and medication management approaches for nicotine dependence treatment in mental health settings. Treatment manuals, training programs, and clinical studies are needed. Such therapies should reflect the unique needs of this population, and be """"""""real world applicable."""""""" This grant reapplication responds to the concerns and helpful suggestions of the initial Review Committee and proposes to further develop and pilot test our behavioral therapy approach of Treating Addiction to Nicotine in Schizophrenia (TANS). In response to the Review Committee, this reapplication clarifies and better links TANS to its the empirical foundation, addresses """"""""real world applicability,"""""""" changes the control treatment, and modifies the assessment battery. We propose to develop and test Stage 1 Therapy Development Products (therapy manual, adherence scales, and training program) of TANS and our new control treatment of Nicotine Dependence Medication Management by Mental Health Providers (Medication Management). We agree with the Review Committee's suggestion to compare TANS to a lower intensity control treatment in regards to (1) engagement, retention, and extended abstinence during the initial three months, (2) relapse prevention during months four through six, and (3) longer-term abstinence at later follow-ups. After an initial open trial of 20 subjects to develop the therapy products, we propose to do a larger study of 100 subjects randomized to TANS versus Medication Management. The proposed study is important because it will create two real world applicable psychosocial treatments that could help clinicians in the mental health system better address tobacco and researchers doing medication or Stage II therapy studies. The study will assess whether medication management is sufficient in this population, and whether lengthening treatment will improve long-term outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
3R01DA015537-03S1
Application #
7161662
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Grossman, Debra
Project Start
2003-07-05
Project End
2007-06-30
Budget Start
2005-07-01
Budget End
2006-06-30
Support Year
3
Fiscal Year
2006
Total Cost
$97,188
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Psychiatry
Type
Schools of Medicine
DUNS #
617022384
City
Piscataway
State
NJ
Country
United States
Zip Code
08854
Williams, Jill M; Zimmermann, Mia Hanos; Steinberg, Marc L et al. (2011) A comprehensive model for mental health tobacco recovery in new jersey. Adm Policy Ment Health 38:368-83
Williams, Jill M; Steinberg, Marc L; Zimmermann, Mia Hanos et al. (2010) Comparison of two intensities of tobacco dependence counseling in schizophrenia and schizoaffective disorder. J Subst Abuse Treat 38:384-93
Gandhi, K K; Foulds, J; Steinberg, M B et al. (2009) Lower quit rates among African American and Latino menthol cigarette smokers at a tobacco treatment clinic. Int J Clin Pract 63:360-7
Ziedonis, Douglas; Hitsman, Brian; Beckham, Jean C et al. (2008) Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine Tob Res 10:1691-715
Williams, Jill M; Gandhi, Kunal K; Steinberg, Marc L et al. (2007) Higher nicotine and carbon monoxide levels in menthol cigarette smokers with and without schizophrenia. Nicotine Tob Res 9:873-81
Yanos, Philip T; Ziedonis, Douglas M (2006) The patient-oriented clinician-researcher: advantages and challenges of being a double agent. Psychiatr Serv 57:249-53
Sussner, Bradley D; Smelson, David A; Rodrigues, Stephanie et al. (2006) The validity and reliability of a brief measure of cocaine craving. Drug Alcohol Depend 83:233-7
Foulds, Jonathan; Steinberg, Michael B; Williams, Jill M et al. (2006) Developments in pharmacotherapy for tobacco dependence: past, present and future. Drug Alcohol Rev 25:59-71
Smelson, David A; Ziedonis, Douglas; Williams, John et al. (2006) The efficacy of olanzapine for decreasing cue-elicited craving in individuals with schizophrenia and cocaine dependence: a preliminary report. J Clin Psychopharmacol 26:9-12
Ziedonis, Douglas M; Guydish, Joseph; Williams, Jill et al. (2006) Barriers and solutions to addressing tobacco dependence in addiction treatment programs. Alcohol Res Health 29:228-35

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