Smoking cessation is the most important strategy available to reduce lung cancer risk. To date, there has been no research on tobacco cessation in lung screening patients, who may have unique attributes (e.g., anxiety about having a nodule coupled with tobacco dependence). We thus propose to evaluate 2 novel behavioral interventions as adjuncts to standard pharmacotherapy. We will enroll and randomize 276 patients undergoing lung screening to Intervention 1 (gain-framed personalized video and print intervention). We will evaluate whether this will improve tobacco quit rates above and beyond standard of care smoking cessation treatment over 8 weeks. Then we will perform a second randomization to Intervention 2, an individual-level, biofeedback intervention. We will then evaluate whether this intervention will reduce smoking rates at 6 months.
This research is a randomized smoking cessation trial conducted within and specifically personalized for lung cancer screening patients presenting to a lung screening clinic. Novel tobacco treatments for this population are critically needed, given the growing population of lung screening patients. In the proposed study, we will test a gain-framed messaging intervention specifically designed for lung screening patients (vs. unframed messaging), as well as evaluating NRT sampling (vs. no medication).
The study will compare two sets of professionally-recommended guidelines for follow-up of patients with small lung nodules. The two guidelines are different in the frequency and timing of follow-up; one is more frequent and the one is less frequent. All patients who have a small lung nodule detected on a chest scan will have a recommended follow-up schedule automatically inserted into their imaging report so that their health care provider may follow the guideline-recommended intervals for follow-up chest scans. Patients and their physicians may choose not to follow the recommendations, depending on preference or the physician's clinical judgment. As part of this research study, information from patients with a small lung nodule who are seen at MUSC will be collected from the electronic medical record. This will include characteristics of the patient (such as age, smoking history), basic information about the lung nodule (such as nodule size, nodule density), and the medical care received.
The purpose of this study is to assess the effects of N-Acetylcysteine (NAC), an over-the-counter antioxidant, to assist adult cigarette smokers with quitting and preventing relapse to smoking. This medication may help people quit smoking by reducing withdrawal symptoms, craving, and preventing relapse, but we do not know if NAC helps smokers early in their quit attempt or after they have already quit.
This study is investigating the effects of combining 2 medications, Varenicline (commonly known as Chantix®) and N-acetylcysteine, on smoking behavior in daily cigarette smokers who are interested in quitting smoking. The study consists of 10 visits over 6 weeks. Compensation is available for those that qualify. Smokers must be between the ages of 18 and 55.
CREST-2 is two parallel multi-center randomized, observer-blinded endpoint clinical trials. One trial will assess treatment differences between intensive medical management alone compared to carotid endarterectomy procedure plus intensive medical management. The parallel trial will assess treatment differences between intensive medical management alone compared to carotid artery stenting plus intensive medical management. Intensive medical management will involve control of blood pressure, LDL cholesterol, cigarette smoking, and other vascular risk factors.
Nicotine dependence remains a significant public health concern. Nicotine can affect brain neural oscillations. A magnetic field applied to the outside of the skull can produce electrical activity in the brain without significant pain or the need for anesthesia. In this proposal, we will build an individual brain signal-driven transcranial magnetic stimulation loop, and then test whether this stimulation loop can modulate neural oscillations and reduce cue-induced craving, including nicotine craving. This research will build an innovative brain stimulation method for neuroscientific research and develop a potential efficacy therapy for nicotine dependence as well other neuropsychiatric disorders.
This research is being conducted at the Medical University of South Carolina Institute of Psychiatry Brain Stimulation Lab by Dr. Mark George to see if deep repetitive transcranial magnetic stimulation (dTMS) is effective in assisting participants to quit smoking. TMS is a noninvasive medical procedure that uses magnetic fields to stimulate nerve cells in the brain to act as an aid to smoking cessation. The treatment period will involve 18 active/sham treatments to be given daily for 3 weeks then weekly treatments in week 4, 5, and 6. A follow up visit will be scheduled about 2 1/2 months after week 6. The entire study is four months in duration. Participants who may be recruited into the study would include the following: men and women 22-70 years of age, chronic; heavy smokers who have smoked for more than 1 year, with no period of abstinence greater than 3 months during the past year; subjects who are motivated to quit smoking; subjects who have negative answers on the TASS; and those who are able to sign an informed consent.
Cigarette smoking causes significant morbidity and mortality in the United States. Smoking cessation is difficult, with the average smoker attempting to quit five times before permanent success. Moreover, the majority of smoking quit attempts result in relapse. Brain stimulation for smoke cessation is an exciting new area that builds on advancing neuroscience knowledge concerning the functional neurocircuitry of addiction. Cortical stimulation can now be performed non-invasively by transcranial magnetic stimulation (TMS). Several studies have shown that TMS can reduce cue-elicited craving in smokers. Previous research by our group has shown that a single session of 15 minutes high frequency (10 Hz) repetitive TMS (rTMS) at 100% motor threshold over the left dorsal lateral prefrontal cortex (DLPFC) can reduce cue-induced craving compared to sham TMS. However, the mechanism by which craving is reduced by rTMS is poorly understood both at behavioral and neural levels. Neuroimaging studies in nicotine dependence have revealed cue-related responses in numerous brain areas, including frontal, parietal cortices and subcortical areas. Recently functional magnetic resonance imaging (fMRI) studies by our group have shown that cue-induced craving induced brain activation in ventral medial prefrontal cortex (VMPFC), including medial frontal, orbital frontal and anterior cingulate. This Chair Research Development Fund (CRDF) pilot proposal will integrate two new techniques- TMS and fMRI to investigate DLPFC-VMPFC pathway in smokers. Using double-masked methods we hypothesize that cue-induced exposure will induce brain activity in VMPFC, and 15 minutes rTMS over DLPFC will reduce cue-induced craving through modulating DLPFC-VMPFC pathway (increased activity DLPFC and decreased activity VMPFC). In the one year of project, we plan to recruit 10 non-treatment-seeking nicotine-dependent cigarette smokers and 20 non-smoking participants, both males and females of all ethnic and racial groups between the ages of 18 and 60 to participate in the study. The participants will randomly receive two different types of brain stimulation: active rTMS or sham rTMS over the left DLPFC with a 1 week interval between treatments. MRI scans will be completed pre and post rTMS. The data from this pilot will provide the information needed for submitting a larger-scale investigation (R01) to investigate cue craving neutral pathway and develop a potential clinical applications of TMS in smoke cessation.
Cigarette smoking is the leading preventable cause of death and disability in the U.S. and individuals with elevated depression symptoms or clinically diagnosed major depressive disorder (MDD) smoke at significantly higher rates than non-depressed individuals. Elevated negative affect and affective dysregulated emotional control may contribute to greater smoking among individuals with MDD. The proposed research will shed new light on the neural mechanisms that govern associations between depression and smoking. Despite known and costly associations between these factors, little is known regarding their co-occurrence and such information will provide a foundation for the development of novel and more effective interventions. We are recruiting adult smokers and nonsmokers, and individuals with or without depression, ages 18 and older to participate.