A new Yale center dedicated to under-,standing why it is so hard for smokers to quit is seeking volunteers for two research projects.

The studies by the Center for Nicotine and Tobacco Use Research at Yale (CENTURY) will seek answers to questions such as "why do some women, people who drink and people who are depressed find it so hard to quit smoking?" and "why do some smoking cessation drugs work when others don't?"

One study will examine the novel use of an existing drug as a possible treatment for smoking. The other will examine why treatment-resistant smokers find it hard to quit. Both studies are seeking participants who want to quit smoking.

According to published research, a significant percentage of those who smoke a pack or more a day report failure in trying to quit or cut back. Those who are able to quit usually require several attempts.

Both Yale studies address that reality. One study, led by Stephanie O'Malley, professor of psychiatry at the School of Medicine, will investigate whether the drug naltrexone, used in combination with the nicotine patch, can help people quit smoking. In addition, the study will look at the effects of naltrexone on the craving for cigarettes, weight gain following quitting and alcohol consumption.

Suchitra Krishnan-Sarin, assistant professor of psychiatry at the School of Medicine, is the lead investigator on the other study, which will try to determine the best treatment for smokers who have a particularly hard time quitting, such as women, drinkers and people who are depressed. Krishnan-Sarin says research shows that these are the subgroups that often relapse.

Participants in this study will join a one-month intensive smoking cessation program that will teach them how to quit and prevent relapse. It also will reward abstinence from smoking with increasing amounts of money. This program will not use any drugs to assist smoking cessation.

"Rewarding people for not smoking has been shown to successfully reduce smoking rates," said Krishnan-Sarin. "Our experience to date indicates very high quit rates, approximately 90% at the end of the first week of not smoking."

O'Malley notes that Nov. 15 was the 25th anniversary of the Great American Smokeout, a day designed to encourage smokers to kick the habit.

"The campaign to combat the dangers of smoking and tobacco use has come a long way in the last 25 years, but there are people out there who still need help," says O'Malley, who is also director of the Division of Substance Abuse Research at the School of Medicine. "These studies could provide additional information to help those who still have difficulty quitting."

The two studies are part of a five-year $10 million grant from the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI) and the Robert Wood Johnson Foundation. The grant has been used to create the Transdisciplinary Tobacco Use Research Center at Yale (TTURC). (See related story.)

Both projects will be supported by an interdisciplinary effort involving investigators with a broad range of expertise. Team members include Yale experts in smoking cessation (Dr. Tony George, assistant professor of psychiatry); naltrexone and alcohol treatment (O'Malley and Dr. Bruce J. Rounsaville, professor and lecturer in psychiatry); weight management (Kelly Brownell, professor and director of graduate studies in psychology and director of the Center for Eating and Weight Disorders); laboratory medicine (Dr. Peter Jatlow, professor and chair of laboratory medicine and professor of psychiatry); the neurobiology of nicotine dependence (Krishnan-Sarin); cue exposure (Rajita Sinha, associate professor of psychiatry); and smoking urges in nicotine-dependent people (Ned L. Cooney, associate professor of psychiatry).

People who are interested in participating in the study should contact Michelle Land at (203) 974-7588.

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