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Combined intranasal oxytocin and mindfulness training as a novel treatment for smoking cessation

Institution: University of Southern California
Investigator(s): Matthew Kirkpatrick,
Award Cycle: 2019 (Cycle 29) Grant #: T29IR0452 Award: $1,231,893
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: High Impact Research Project Award

Initial Award Abstract
High trait hostility (a symptomatic feature of several psychiatric and personality disorders that are all associated with smoking) is itself associated with a higher incidence of smoking and greater rates of relapse. Thus, it is critical to develop treatments that can be specifically tailored to smokers with high trait hostility. In this lab study, we propose to develop a novel, treatment strategy that merges a pharmacological (intranasal oxytocin [inOT]) with a behavioral treatment (the attention- and emotion-regulation discipline of mindfulness training [MT]), to support a reduction in stress-induced anxiety, craving, and smoking lapse among smokers with high trait hostility in withdrawal. Oxytocin is a naturally occurring hormone involved in brain drug reward. Recent studies (including our ongoing high impact pilot study: TRDRP 25IP-0021) indicate that acute inOT administration is an anxiolytic and reduces tobacco craving and smoking lapse during abstinence, especially among those with high hostility. MT is an empirically tested psychotherapeutic program that, similar to inOT, may be efficacious in reducing tobacco craving and anxiety during smoking abstinence. Thus, MT and inOT exposures share common anxiolytic effects that might function in concert to reduce tobacco craving via similar mechanisms of action. In this experimental laboratory study, we propose to test the combined effects of MT (or a control: cMT) and inOT in N=200 smokers during acute abstinence. Smokers will be randomly assigned to one of four exposures: MT+inOT, MT+placebo, cMT+inOT, or cMT+placebo. This will allow us to examine the impact of each treatment alone and in combination on craving and anxiety as well as cortisol levels and heart rate variability following a stress task (Trier Social Stress Test). We hypothesize that: 1) MT and inOT alone will reduce stress-induced craving, anxiety, and cortisol levels compared to controls; and 2) MT in combination with inOT will amplify the effects of either treatment alone. Positive findings will provide evidence for the development of a new accessible treatment for smoking cessation that may be particularly helpful for individuals with high trait hostility, who may be unlikely to do well in other effective socially-focused behavioral treatment program (e.g., group cessation programs).