Nicotine Dependence Treatment in Psychiatric Comorbidity

Nicotine dependence is very common among psychiatric patients and impacts clinical course, medication levels, and physical health of smokers. Unfortunately, there is a paucity of research for this subgroup of smokers and minimal treatment studies. The goals of this NIDA Mentored Patient-Oriented Research Career Development Award (K23) are to become an independent clinical researcher and create a program of research in the area of nicotine dependence and psychiatric comorbidity. This includes further training in Epidemiology and Quantitative Methods including research methodology, biostatistics and biocomputing, experiment design, process research and comorbidity issues. The UMDNJ-Robert Wood Johnson Medical School and the Rutgers Center for Alcohol Studies provide an excellent environment for developing research investigators. The primary mentor, Douglas Ziedonis, had extensive research experience, a NIDA Career Award, and is a leading psychiatrist studying nicotine dependence among individuals with schizophrenia. The research plan includes two studies. 1: Pharmacotherapy for Nicotine Dependence Among Psychiatric Patients. During a six-month study, schizophrenic smokers will be recruited into a double blind study comparing multiple doses of nicotine replacement pact .schizophrenics are believed to be more heavily dependent on nicotine, therefore, higher dose strategies and longer duration of treatment may yield greater quit rates. Study 2: Psychosocial Treatment for Nicotine Dependence Among Psychiatric Patients. Using NIDA stage a Behavioral Therapy approach, the specific aims of this study are to develop patient and clinical manuals, create adherence and rating scales and formalize a training program for clinicians and conduct a pilot study. Schizophrenics have unique disabilities in processing information and interpersonal communications that require specific and tailored therapies. Techniques from dual diagnosis treatment can be adapted for treating nicotine dependence and include aspects of social skills training, motivational enhancement therapy and relapse prevention.