Smoking relapse targeted in $9.9 million study

Relapse prevention will be focus of five-year effort

Using an array of technology that will include hand-held computers and magnetic resonance imaging of the brain, research teams at the UW Medical School will launch a comprehensive assault on one of the most persistent problems in smoking cessation: relapse.

The Center for Tobacco Research and Intervention (CTRI) at the Medical School will conduct that assault with a $9.9 million grant from the National Cancer Institute and the National Institute on Drug Abuse (NIDA), university officials announced today (Oct. 18, 1999).

The largest grant in CTRI history, it will be used to fund a series of tobacco-related studies. One of only seven institutions nationwide to receive such a grant, the UW is the only institution in the nation to receive an award for research projects targeted at examining relapse to tobacco use, the largest challenge in the search for a method of controlling tobacco addiction.

“In the United States this year, one-third of all smokers — representing 20 million adults — will try to quit smoking,” said Michael Fiore, CTRI director. “Unfortunately, only one million will succeed. The purpose of our research will be to try to change this discouraging statistic. By investigating why people relapse to smoking, we believe we can help people who want to quit succeed in doing so.”

The grant dollars will be used to fund three major research projects, training for tobacco researchers and a pilot grant research program. Fiore, along with Timothy B. Baker, a professor in the Department of Psychology, will serve as principal investigators on the three research projects, each focusing on a different aspect of tobacco relapse.

The research projects will include the following:

A study designed to identify and examine negative affect and withdrawal symptoms that often contribute to smoking relapse. In this study, test patients will use palm-top computers to record their reactions and symptoms as they proceed through three different smoking cessation programs.
A study of the effectiveness of computer-based prevention of smoking relapse. This project will analyze the nature of smoking relapse and develop and test a computer-based treatment to help reduce relapse risk. Smokers who have successfully quit will be exposed to therapy options of varying intensity, including the Internet and a UW-developed resource known as CHESS — the Comprehensive Health Enhancement Support System, a computer-guided network of information, emotional support and problem-solving assistance.
A study assessing tobacco dependence. Proceeding from the theory that physical and psychological dependence on tobacco are the largest factors in smoking relapse, this project seeks to understand smoking relapse more clearly by tracking and measuring the symptoms of recovering smokers.

Pilot programs
In addition to the three major research studies, the NIDA grant will also make possible three pilot studies examining the phenomenon of tobacco relapse.

The first pilot study will examine nicotine and exercise-related energy expenditure in women, based on the assumption that many women smoke as a method of weight control and fail to quit for fear of gaining weight. Researchers under the direction of Douglas E. Jorenby, an assistant professor of medicine, will monitor the progress of 20 females, each a regular smoker, as they participate in a series of nicotine replacement and exercise programs. The goal is a better understanding of how tobacco cessation affects metabolic recovery time.

The second pilot program, under the direction of Michael L. Rothschild, a professor in the School of Business, will use social marketing theories to increase smoking cessation. Primary care clinicians will be provided with a quick-care reference guide to help them assist patients who want to quit. A post-marketing survey will then be used to evaluate the effectiveness of the reference guide.

The third pilot program will use functional magnetic resonance imaging (fMRI) sessions to monitor the impact of tobacco withdrawal and anticipation on various areas of the brain, including two of the areas that researchers believe spark drug motivation. Richard J. Davidson, the Vilas Professor in the departments of psychology and psychiatry, will serve as principal investigator.

Other institutions receiving NIDA/NCI grants related to tobacco use research are the Brown University Center for Behavioral and Preventive Medicine; the University of California, Irvine; the University of Southern California; Georgetown University; the University of Minnesota, Minneapolis; and Yale University.

NIDA supports more than 85 percent of the world’s research on the health aspects of drug abuse and addiction. More information about NIDA research is available on its home page, http://www.drugabuse.gov.