 |
Purpose |
|
Goals |
|
Research Priorities |
|
Funders |
| |
|
|
Purpose
The purpose of the TTURCs is to facilitate a transdisciplinary approach to the full spectrum of basic and applied research on tobacco use to reduce the disease burden of tobacco use, including: |
|
|
Etiology of tobacco use and addiction
|
|
|
Impact of advertising and marketing
|
|
|
Prevention of tobacco use
|
|
|
Treatment of tobacco use and addiction
|
|
|
Identification of biomarkers of tobacco exposure
|
|
|
Identification of genes related to addiction and susceptibility to harm from tobacco |
| |
|
| Goals |
|
|
Increase the number of investigators from relevant disciplines who focus on the study of tobacco use as part of transdisciplinary teams.
|
|
|
Generate basic research evidence to improve understanding of the etiology and natural history of tobacco use.
|
|
|
Produce evidence-based tobacco use interventions that can translate to the community and specific understudied or underserved populations.
|
|
|
Increase the number of evidence-based interventions that are novel, including the development, testing and dissemination of innovative behavioral treatments and prevention strategies based upon findings from basic research.
|
|
|
Train transdisciplinary investigators capable of conducting cutting-edge tobacco use research.
|
|
Increase the number of peer-reviewed publications in the areas of tobacco use, nicotine addiction, and treatment. |
| |
|
| Research Priorities |
| |
Adolescents & Young Adults
Recent advances have identified key factors – genetic, social and environmental – that contribute to the etiology of youth tobacco use. Yet, key research questions remain: Are there critical social or environmental events that together with a genetic predisposition to nicotine addiction increase or decrease the likelihood that young tobacco users will become addicted? And, if we can identify those at greatest genetic risk, are there pharmacological (e.g. vaccine) or social (e.g. counter-advertising) interventions that can prevent tobacco use from progressing to addiction?
|
| |
Women (gender differences)
Some clinical studies have suggested that women have more difficulty quitting than men, suggesting that there may be broader gender differences in the nature of nicotine addiction. Important research questions include the nature of genetic/biologic factors that interact with gender in explaining treatment response, whether treatment impacts be improved by addressing social and cultural variables, and the salience of gene-hormone-environment interactions in gender differences in tobacco use and cancer susceptibility. The other broad issue that relates to women is smoking during pregnancy, and the consequences for fetal and post-natal development.
|
| |
Psychiatric Comorbidity
Tobacco use is higher and cessation rates are lower among some psychiatric populations (e.g., depression, schizophrenia). What are their common pathways? How does tobacco use, treatment and cessation affect psychiatric symptomotology? Is it possible to effectively treat tobacco dependence when psychiatric conditions have not been addressed?
|
| |
Concurrent Tobacco and Alcohol Abuse/Dependence
The high comorbidity between alcohol and tobacco abuse/dependence presents health risks over and above the risks posed by smoking or alcohol consumption alone. What are the mechanisms underlying the conjoint use of these substances and how might the understanding of this linkage at the molecular, genetic, pharmacokinetic and behavioral levels inform the development effective treatments for concurrent use?
|
| |
Disparities
There are disproportionate rates of smoking among those of low income, less education, American Indian/Alaskan Natives, Southeast Asians, the unemployed, and particular categories of workers (e.g. blue collar, service workers, and farm workers). How do social contextual (e.g. social networks, social ties, discrimination, historical factors) variables contribute to these disparities? And how do social context factors interact with genetic, biological factors, chemical exposures, type of tobacco product (especially new products), and brand (i.e. menthol)? Finally, in what ways might individual, quit-line, health care system-based treatments of tobacco dependence be improved to address disparities?
|
| |
Treatment Development
Treatments of smoking over the past decade have yielded successes but there is substantial room for improvement in outcomes. How might understanding of the relationship between negative emotions and cognitive processing translate to the development of novel smoking cessation interventions? Are there behavioral, health care system, or policy approaches that can be developed that will increase the use and effectiveness of existing smoking treatments so that cessation is more likely?
|
| |
Treatment Delivery
There is a need to understand how to improve treatment delivery. Components of this might include enhancement of treatment-seeking behavior, health systems augmentations that would facilitate entry to and compensation for treatment services, and system integration that would allow logical and effective cohesion between various extant elements, such as quit lines, primary treatment providers, etc. How might the development of technological devices (e.g., personal digital assistants, virtual reality) be used in the delivery of treatments? Population-based approaches (i.e., defined populations) are particularly encouraged.
|
| |
Genetic Influences on Nicotine Dependence
There is consensus that nicotine addiction is a result of a gene-environment interaction, yet far more research is needed on which gene variants are critical for the development and maintenance of addiction. Are there multiple gene patterns that increase the likelihood of nicotine addiction, or perhaps specific gene variants that can be triggered by pharmacologic agents that will decrease the likelihood of becoming dependent? And is it possible to tailor specific behavioral or pharmacological treatments for a specific genotype? Understanding the patterns of tobacco use behavior and the relationship between tobacco use and use of other drugs may help us identify unique phenotypes or endophenotypes for genetic analyses.
|
| |
Medication Development
There is a need for new medications to treat various aspects of tobacco addiction, such as the reinforcing effects of nicotine and early relapse. One broad approach would be to develop and validate new nicotine delivery systems to mimic the rapid delivery of nicotine produced by the inhalation of tobacco smoke, but with much reduced toxicity. Another promising approach would exploit the maturing neuroscience of tobacco addiction, including the discovery of new neurochemical systems and molecular targets in addiction, withdrawal and relapse, and our increasing knowledge of the prominent conditioned effects that play a role in tobacco addiction. |
| |
|
| Funders |
| |
National Cancer Institute (NCI)
http://www.cancer.gov
National Institute on Drug Abuse (NIDA)
http://www.drugabuse.gov
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
http://www.niaaa.nih.gov
|
