Neuroinflammation and Smoking Cessation Treatment Response

Cigarette smokers are known to have impaired inflammation in the body.  As a result, smokers are often instructed not to smoke within 4 weeks of having surgery, so that healing in the body will not be impaired by the effects of smoking.  A recent positron emission tomography (PET) scanning study by our group demonstrated that smokers who smoke to satiety have abnormally low levels of inflammatory function in the brain, while additional pilot data for this grant application suggests that 3 days of not smoking (peak withdrawal) leads to increased brain inflammation (above normal).  For this proposed High Impact Research Project Award, Veterans who are cigarette smokers seeking to attempt abstinence will undergo two PET scans to measure a marker for brain inflammation; one scan at satiety and one at 3 days abstinence. This will be followed by 12-weeks of standard treatment (group therapy plus nicotine patch).  Smoking behavior will be monitored weekly during treatment, and quit status will be determined at the end of treatment.  Non-smokers will undergo the same type of PET scanning twice as a control group.  We anticipate that smokers will have low levels of the PET scanning marker for brain inflammation during satiety and abnormally high levels of the marker for brain inflammation during peak withdrawal, whereas non-smokers will have little difference on the PET scanning measure between the two scans.  Additionally, and consistent with other prior PET scanning research by our group, we anticipate that Veteran smokers with greater abnormalities on the pre-treatment PET scans will have less likelihood of quitting smoking with standard treatment.  While there are well-studied clinical predictors of quitting, such as level of dependence on cigarettes, craving soon after smoking, and self-confidence, we anticipate that the PET scanning measure we are investigating in this study will provide additional ability to predict quitting, which could (in the long run) help personalize treatment for cigarette smokers.