The majority of substance dependent persons in recovery smoke cigarettes. Many of these persons are concerned about the effect of smoking on their health and many have unsuccessfully tried to quit smoking. Clinical trials have reported very low quit rates with this population. Failure to use nicotine replacement therapy and underdosing when nicotine replacement has been used may account for these very low quit rates. The major specific aim of this application is to evaluate the impact of 2 different doses of nicotine replacement therapy on smoking quit rates in a sample of smokers in substance abuse recovery who want to quit smoking. This project will also investigate the mechanism(s) accounting for the efficacy of the NP. Substance abusing smokers with between 3 and 12 months of abstinence from non-nicotine drugs will be randomly assigned in a double-blind manner to 1 of 2 conditions. Subjects in condition 1 will receive a 22-mg NP for 8 weeks and an 11-mg NP for 4 weeks. Subjects in condition 2 will receive a 44-mg NP for 4 weeks, a 22-mg NP for 4 weeks and an 11-mg NP for 4 weeks. All subjects will also receive supportive-behavioral group counseling. Smoking outcome will be measured at the end of treatment, and 12 and 24 weeks following end of treatment. Intensive assessments of smoking and other variables will be made on a daily basis for the first week post-quit and on a weekly basis for the remainder of the counseling phase of a subject's participation. Since many recovering substance abusers die of smoking-related illnesses, treatments with demonstrated effectiveness with this population are urgently needed. This project will provide critical information about the differential effects of 2 doses of NP with this population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
1R29DA011713-01
Application #
2593416
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Montoya, Ivan
Project Start
1998-08-05
Project End
2003-06-30
Budget Start
1998-08-05
Budget End
1999-06-30
Support Year
1
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Brown University
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Kalman, David; Kahler, Christopher W; Garvey, Arthur J et al. (2006) High-dose nicotine patch therapy for smokers with a history of alcohol dependence: 36-week outcomes. J Subst Abuse Treat 30:213-7
Kalman, David; Morissette, Sandra Baker; George, Tony P (2005) Co-morbidity of smoking in patients with psychiatric and substance use disorders. Am J Addict 14:106-23
Kalman, David; Kahler, Christopher W; Tirch, Dennis et al. (2004) Twelve-week outcomes from an investigation of high-dose nicotine patch therapy for heavy smokers with a past history of alcohol dependence. Psychol Addict Behav 18:78-82
Kalman, David (2002) The subjective effects of nicotine: methodological issues, a review of experimental studies, and recommendations for future research. Nicotine Tob Res 4:25-70
Kalman, David; Tirch, Dennis; Penk, Walter et al. (2002) An investigation of predictors of nicotine abstinence in a smoking cessation treatment study of smokers with a past history of alcohol dependence. Psychol Addict Behav 16:346-9