Brain Nicotine Receptor Density & Response to Nicotine Patch



Status:Not yet recruiting
Conditions:Smoking Cessation
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:18 - 55
Updated:2/7/2015
Start Date:March 2012
Contact:Arthur L Brody, M.D.
Email:abrody@ucla.edu
Phone:310-478-3711

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Even though the health risks and societal costs of cigarette smoking are well-known, roughly
19.8% of American adults continue to smoke. While most smokers endorse a desire to quit,
very few (< 5%) will actually quit in a given year without treatment, and only about 20-25%
achieve abstinence after 6 months or more of effective treatment. Therefore, there continues
to be a vital need to improve outcomes for cigarette smokers seeking treatment. Current
first-line medications for Tobacco Dependence include nicotine replacement therapies (such
as the patch, gum, lozenge, nasal spray, and inhaler), varenicline HCl (Chantix), and
bupropion HCl (Zyban), with the current standard of care in most treatment settings being to
choose specific medications based primarily on availability, ease of use, and patient
preference. The goal of the proposed research is to improve the delivery of smoking
cessation treatment by determining if pre-treatment nicotine receptor density in cigarette
smokers is associated with smoking cessation outcome with the standard nicotine patch taper.
The study's main hypothesis is that cigarette smokers with less pre-treatment upregulation
of nicotine receptors will have a greater likelihood of quitting smoking from a standard
course of nicotine patch treatment than smokers with more up-regulation of these receptors.
Positron emission tomography (PET) will be used to test this hypothesis.


Inclusion Criteria:

- Healthy adult who is a tobacco dependent smoker (smokes 10-30 cigarettes per day)
meeting criteria for Nicotine Dependence as defined by DSM-IV criteria

- Has the desire to quit smoking

- Ability to read, write, and give voluntary informed consent

- An exhaled CO greater than or equal to 8 ppm during the study screening visit to
verify smoking status

Exclusion Criteria:

- Any history of an Axis I psychiatric diagnosis other than Nicotine Dependence
(including other substance abuse/dependence and mood, anxiety, and psychotic
disorders)

- Any current medication or any history of a medical condition that might affect the
central nervous system at the time of scanning (e.g., current treatment with a
psychotropic medication, or history of severe head trauma or epilepsy).

- Unstable cardiovascular disease, liver disease, or renal insufficiency. Routine
history and physical examination will be performed at the initial screening visit to
insure that participants meet study criteria

- Pregnancy (urine pregnancy tests will be obtained on all women of child-bearing
potential) due to the theoretical risk of radiation exposure to the fetus.
Pre-menopausal women will only be scanned during the early follicular phase (by
participant report) of the menstrual cycle because hormonal levels have been shown to
affect nicotine metabolism.

- Caffeine dependence, as evidenced by withdrawal symptoms temporally associated with
caffeine ingestion.
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