Kimber P. Richter, Ph.D., M.P.H., is a behavioral psychologist with training in public health who will use the MRSDA to develop expertise in addressing nicotine addiction among persons in drug abuse treatment, an estimated 80 percent of whom smoke. The proposal combines her behavioral background in drug abuse prevention, drug abuse treatment, and cardiovascular disease risk reduction with a new focus on smoking cessation. This plan outlines the training and research experience she will need, over the next 5 years, to develop and launch a fully independent career addressing nicotine addiction among persons in drug abuse treatment. Career Development: Activities include training in the chemistry of the nervous system, advanced biostatistics, training in addictions treatment and research, a week-long internship with a nicotine/drug addictions researcher, and an intensive bioethics course. Research Program: The goal of the proposed research program is to better understand smoking behaviors and nicotine dependence among persons in treatment for chemical dependencies, and to identify acceptable and potentially effective methods for reducing cigarette smoking in this population. Specifically, the plan involves three studies that address five research questions. Study 1 examines key issues in smoking cessation from the patient's point of view. It consists of a series of two focus groups among each of four subgroups of clients in methadone maintenance treatment (MMT) and other drug dependency programs. These 8 sessions is will identify clients' a) interest in quitting, b) barriers to quitting smoking, c) successful strategies used to quit smoking, d) strategies used to avoid illicit drug use that might be adapted for smoking cessation, and e) treatment preferences for quitting smoking. Study 2 is a descriptive study examining interactions in patterns of cigarette use and methadone maintenance. Twenty-one methadone patients will use electronic monitors to record the frequency and timing of their cigarette consumption. Data on methadone timing and dose, as well as carbon monoxide levels and psychological measures of nicotine craving and withdrawal, will be collected and analyzed to assess whether methadone dose and timing are associated with surges in cigarette consumption and smoking urges. Study 3 is a pilot study examining the feasibility and potential efficacy of a multicomponent intervention on smoking cessation. Sixty MMT patients will be randomly assigned to treatment (nicotine inhaler and motivational interviewing) or control (placebo inhaler and comparable staff contact). Primary outcomes include quit rates and avg. daily cigarette use. Pilot data will allow determination of sample sizes for a full-scale intervention trial, and will be used to assess the effects of variables such as age, gender, methadone dose on treatment effects. The research plan uses exploratory, descriptive, and intervention research to address fundamental issues of nicotine addiction. Each study stands on its own, but is designed to build on the findings of the prior study. This research may serve as a model for systematic research on nicotine addiction in patients with other drugs of dependence or who are in other drug abuse treatment modes.
| Friedmann, Peter D; Jiang, Lan; Richter, Kimber P (2008) Cigarette smoking cessation services in outpatient substance abuse treatment programs in the United States. J Subst Abuse Treat 34:165-72 |
| Richter, Kimber P; Hamilton, Ashley K; Hall, Sandra et al. (2007) Patterns of smoking and methadone dose in drug treatment patients. Exp Clin Psychopharmacol 15:144-53 |
| Richter, Kimber P (2006) Good and bad times for treating cigarette smoking in drug treatment. J Psychoactive Drugs 38:311-5 |
| Richter, Kimber P; McCool, Robert M; Catley, Delwyn et al. (2005) Dual pharmacotherapy and motivational interviewing for tobacco dependence among drug treatment patients. J Addict Dis 24:79-90 |
| Richter, Kimber P; Choi, Won S; McCool, Robert M et al. (2004) Smoking cessation services in U.S. methadone maintenance facilities. Psychiatr Serv 55:1258-64 |
| Richter, Kimber P; Kaur, Haroshena; Resnicow, Ken et al. (2004) Cigarette smoking among marijuana users in the United States. Subst Abus 25:35-43 |
| McCool, Robert M; Paschall Richter, Kimber (2003) Why do so many drug users smoke? J Subst Abuse Treat 25:43-9 |
| Jolicoeur, Denise G; Richter, Kimber P; Ahluwalia, Jasjit S et al. (2003) Smoking cessation, smoking reduction, and delayed quitting among smokers given nicotine patches and a self-help pamphlet. Subst Abus 24:101-6 |
| Richter, Kimber Paschall; Ahluwalia, Harsohena K; Mosier, Michael C et al. (2002) A population-based study of cigarette smoking among illicit drug users in the United States. Addiction 97:861-9 |
| Richter, Kimber Paschall; McCool, Robert M; Okuyemi, Kolawole S et al. (2002) Patients' views on smoking cessation and tobacco harm reduction during drug treatment. Nicotine Tob Res 4 Suppl 2:S175-82 |
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