VYTP Virginia Youth Tobacco Project

VYTPVYTPVirginia Youth Virginia Youth Tobacco ProjectTobacco Project

Securing the health Securing the health

of Virginia’s youth of Virginia’s youth

through sciencethrough science


Report to Report to The Virginia Tobacco Settlement FoundationThe Virginia Tobacco Settlement Foundation

Board of TrusteesBoard of TrusteesResearch CommitteeResearch Committee

18 March 200318 March 2003

VIRGINIA YOUTHVIRGINIA YOUTHTOBACCO PROJECTTOBACCO PROJECT

COALITION BUILDINGCOALITION BUILDING

Robert L. Balster, Robert L. Balster, PhDPhD

GoalsGoals

Build statewide trans-disciplinary Build statewide trans-disciplinary program of research on causes and program of research on causes and prevention of youth tobacco useprevention of youth tobacco use

Attract faculty scholars to work on Attract faculty scholars to work on problems of youth smokingproblems of youth smoking

Use VTSF funding as base for attracting Use VTSF funding as base for attracting additional outside funding for youth additional outside funding for youth tobacco research in Virginiatobacco research in Virginia

Implementation MethodsImplementation Methods Solicited input from members of the Solicited input from members of the

Virginia Research Consortium (VPRs)Virginia Research Consortium (VPRs) Utilized our knowledge of tobacco experts Utilized our knowledge of tobacco experts

in Virginiain Virginia Identified a contact individual at each Identified a contact individual at each

institution to be included in the first roundinstitution to be included in the first round Obtained proposals from these project PIsObtained proposals from these project PIs Funded four subcontracts in August 2002Funded four subcontracts in August 2002 Hired project director (Randy Koch) in Hired project director (Randy Koch) in

February 2003February 2003

VYTP Coalition:VYTP Coalition:Current ComponentsCurrent Components

GMU (Robert Smith, PI)GMU (Robert Smith, PI)

JMU (Steve Evans, PI)JMU (Steve Evans, PI)

UVA (Richard Bonnie, PI)UVA (Richard Bonnie, PI)

Virginia Tech (Peggy Meszaros, PI)Virginia Tech (Peggy Meszaros, PI)

VCU (Roy Pickens and Bob Balster, VCU (Roy Pickens and Bob Balster, PIs)PIs)

GMU Component: Robert Smith, PIGMU Component: Robert Smith, PIAnimal Model of Adolescent Nicotine Animal Model of Adolescent Nicotine EffectsEffects

Does peri-adolescent nicotine exposure Does peri-adolescent nicotine exposure cause lasting cognitive changes?cause lasting cognitive changes?

Does peri-adolescent nicotine contribute Does peri-adolescent nicotine contribute to increased effort to self administer to increased effort to self administer cocaine?cocaine?

How does peri-adolescent nicotine affect How does peri-adolescent nicotine affect gene expression, evaluating all genes? gene expression, evaluating all genes?

Received separate funding from VTSFReceived separate funding from VTSF

JMU Component: Steven Evans, PIJMU Component: Steven Evans, PITobacco Prevention Research CenterTobacco Prevention Research Center

Subcontract with VCU supports three separate projects Subcontract with VCU supports three separate projects that address risk factors and develop interventions for that address risk factors and develop interventions for preventing and stopping tobacco usepreventing and stopping tobacco use Youth with ADHD (Steven Evans)Youth with ADHD (Steven Evans)

Dieting behavior & weight concerns among adolescents Dieting behavior & weight concerns among adolescents (Monica Reiss-Bergan)(Monica Reiss-Bergan)

Smoking cessation using alternative and complimentary Smoking cessation using alternative and complimentary health practices (Cheryl Talley & Charles Lockett)health practices (Cheryl Talley & Charles Lockett)

Also received separate funding from VTSF for clinical trial Also received separate funding from VTSF for clinical trial workwork

UVA Component: Richard Bonnie, PIUVA Component: Richard Bonnie, PIYouth-Centered Tobacco Policy ResearchYouth-Centered Tobacco Policy Research

Assembled investigative teamAssembled investigative team Richard Bonnie - health policy and ethicsRichard Bonnie - health policy and ethics Michael Moore – health economicsMichael Moore – health economics Pam Kulbock – adolescent healthPam Kulbock – adolescent health Marian Moore – marketing and communicationsMarian Moore – marketing and communications Gerald Clore – social psychologyGerald Clore – social psychology Victor Bovbjerg – epidemiologyVictor Bovbjerg – epidemiology Ruth Gaare Bernheim – policy studiesRuth Gaare Bernheim – policy studies

Established bi-weekly tobacco research Established bi-weekly tobacco research colloquiumcolloquium

UVA ComponentUVA ComponentYouth-Centered Tobacco Policy ResearchYouth-Centered Tobacco Policy Research

Projects UnderwayProjects Underway Econometric studies of effects of policy Econometric studies of effects of policy

interventions on dynamics of youth interventions on dynamics of youth smoking and on low birthweightsmoking and on low birthweight

Study of deterrent effect of youth access Study of deterrent effect of youth access restrictions and their enforcement on restrictions and their enforcement on retailersretailers

Analysis of NAAG MSA EnforcementAnalysis of NAAG MSA Enforcement

UVA ComponentUVA ComponentYouth-Centered Tobacco Policy ResearchYouth-Centered Tobacco Policy Research

Projects in conception and developmentProjects in conception and development Emotional reactions to tobacco advertising and Emotional reactions to tobacco advertising and

counter-advertisingcounter-advertising

Relationship between attributions and cessation Relationship between attributions and cessation outcomesoutcomes

Effects of threatened sanctions for underage Effects of threatened sanctions for underage tobacco and alcohol usetobacco and alcohol use

Conceptual and operational development of Conceptual and operational development of policy-relevant influences on non-smoking policy-relevant influences on non-smoking behavior by young teensbehavior by young teens

Virginia Tech Component: Virginia Tech Component: Peggy Meszaros, PIPeggy Meszaros, PIAdolescent Female SmokingAdolescent Female Smoking

Secondary analysis of data on Virginia Secondary analysis of data on Virginia youth from two surveysyouth from two surveys

Identify risk and protective factorsIdentify risk and protective factors

Evaluate quitting strategies for female Evaluate quitting strategies for female smokerssmokers

Disseminate information on effective Disseminate information on effective interventionsinterventions


INTEGRATEDINTEGRATED

RESEARCH AND EVALUATIONRESEARCH AND EVALUATION

AT VCUAT VCU

Roy W. Pickens, PhDRoy W. Pickens, PhD

Susceptibility to Nicotine Dependence: Susceptibility to Nicotine Dependence: A Complex Developmental ProcessA Complex Developmental Process

Varies with inherited characteristics of Varies with inherited characteristics of individualsindividuals

Varies with the age of usersVaries with the age of users

Depends to some extent on Depends to some extent on environmental influences, from environmental influences, from parents, peers, and the mediaparents, peers, and the media

Manifested in various stages of use Manifested in various stages of use behaviorbehavior

Stages of Development in Adolescent Stages of Development in Adolescent Smoking Behavior: Points of Focus for Smoking Behavior: Points of Focus for Research and InterventionResearch and Intervention

CONTEMPLATINGCONTEMPLATINGCONTEMPLATINGCONTEMPLATING TRYINGTRYINGTRYINGTRYING

USINGUSINGREGULARLYREGULARLY

USINGUSINGREGULARLYREGULARLY USINGUSING

HEAVILYHEAVILY

USINGUSINGHEAVILYHEAVILY

Stage 1Stage 1 Stage 2 Stage 2 Stage 3 Stage 3 Stage 4 Stage 5 Stage 4 Stage 5 Stage 1Stage 1 Stage 2 Stage 2 Stage 3 Stage 3 Stage 4 Stage 5 Stage 4 Stage 5

EXPERIMENTINGEXPERIMENTINGEXPERIMENTINGEXPERIMENTING

Increasing Risk of Nicotine DependencyIncreasing Risk of Nicotine Dependency

Rela

tive N

um

bers

of

Rela

tive N

um

bers

of

Ad

ole

scen

ts/S

tag

e*

Ad

ole

scen

ts/S

tag

e*

* Estimates, based on CDC, “Trends in Cigarette Smoking Among High * Estimates, based on CDC, “Trends in Cigarette Smoking Among High School Students – United States, 1991-2001,” School Students – United States, 1991-2001,” MMRWMMRW 51(19). 51(19).

Current VCU ResearchCurrent VCU ResearchProject ThemesProject Themes Genetic Influence over Tobacco Use in Genetic Influence over Tobacco Use in

AdolescentsAdolescents How These Genetic Influences are How These Genetic Influences are

Expressed in Nicotine PharmacologyExpressed in Nicotine Pharmacology Clinical Trials in Preventing Adolescents’ Clinical Trials in Preventing Adolescents’

Initial Tobacco Use from Progressing to Initial Tobacco Use from Progressing to Nicotine DependencyNicotine Dependency

Evaluation of Community- and School-Evaluation of Community- and School-Based Youth Anti-Tobacco ProgramsBased Youth Anti-Tobacco Programs

Smoking is Highly HeritableSmoking is Highly Heritable

60%26%

14%

Smoking InitiationSmoking Initiation

62%

0%

38%

Smoking PersistenceSmoking Persistence

Non-shared EnvironmentNon-shared Environment

Shared Shared Environment Environment

GenesGenes

Shared Shared Environment Environment

GenesGenes

Non-shared EnvironmentNon-shared Environment

Data presented include females only; males similar.Data presented include females only; males similar.

Approaches to the Study of Genetic Approaches to the Study of Genetic Influence over Tobacco Use and Influence over Tobacco Use and Nicotine DependencyNicotine Dependency Genetic Epidemiology: twin studies to determine Genetic Epidemiology: twin studies to determine

the role of genetic and environmental influences the role of genetic and environmental influences at each stage of tobacco useat each stage of tobacco use

Gene Mapping: the use of epidemiological data to Gene Mapping: the use of epidemiological data to identify suspect chromosomal regionsidentify suspect chromosomal regions

Candidate Gene Studies: identification of genes in Candidate Gene Studies: identification of genes in these chromosomal regions suspected to be these chromosomal regions suspected to be associated with tobacco useassociated with tobacco use

Gene Activation Studies: laboratory investigation Gene Activation Studies: laboratory investigation of gene expression using animal modelsof gene expression using animal models

Project 1. Genetic Epidemiology: Project 1. Genetic Epidemiology: Genetic Factors in the Transition Genetic Factors in the Transition Through Smoking StagesThrough Smoking Stages

Donna Miles, PhD (PI)Donna Miles, PhD (PI)

Roy Pickens, PhDRoy Pickens, PhD

Lindon Eaves, PhD DScLindon Eaves, PhD DSc

Judy Silberg, PhDJudy Silberg, PhD

GoalsGoals

Examine genetic and environmental Examine genetic and environmental factors that play a role in the factors that play a role in the transition between smoking stagestransition between smoking stages

Identify common (shared) and unique Identify common (shared) and unique genetic and environmental influences genetic and environmental influences at each stage of smokingat each stage of smoking

Twin ResearchTwin Research

Longitudinal Twin StudyLongitudinal Twin Study

At VCU we maintain large twin registries, At VCU we maintain large twin registries, under the management of the Mid-Atlantic under the management of the Mid-Atlantic Twin Registry (MATR)Twin Registry (MATR)

We are now conducting an adolescent We are now conducting an adolescent behavioral-development study on 1412 twin behavioral-development study on 1412 twin pairspairs

Subjects first interviewed in adolescence Subjects first interviewed in adolescence (ages 8-16 years old)(ages 8-16 years old)

Currently re-interviewing these twins, who Currently re-interviewing these twins, who are now in young adulthood (ages 20-28 are now in young adulthood (ages 20-28 years)years)

Longitudinal Twin Study: Longitudinal Twin Study: Progress to DateProgress to Date

Secured MATR approvalSecured MATR approval

Secured IRB approvalSecured IRB approval

Obtained NIH Certificate of ConfidentialityObtained NIH Certificate of Confidentiality

Developed telephone interview, which uses Developed telephone interview, which uses Optiscan technologyOptiscan technology

Completed hiring and training telephone Completed hiring and training telephone interviewersinterviewers

Conducted preliminary data analysis on Conducted preliminary data analysis on adolescent sampleadolescent sample

Tobacco Use among TwinsTobacco Use among Twins

0

100

200

300

400

500

600

700

800

900

8 9

10

11

12

13

14

15

16

20

21

22

23

24

25

26

27

28

ever smoked current smoker

# twins# twins

Wave IWave I Current studyCurrent study(completed)(completed) (expected)(expected)

agesages

Future Directions in Twin Research Future Directions in Twin Research at VCUat VCU

December 2002, submitted NIH grant December 2002, submitted NIH grant application entitled “Child application entitled “Child Psychopathology-Adult SUD Longitudinal Psychopathology-Adult SUD Longitudinal Twin Study”Twin Study”

Extends work begun with VTSF fundingExtends work begun with VTSF funding

Based on methods used in VTSF-funded Based on methods used in VTSF-funded projectproject

4 year project4 year project

Total cost, $2,003,614Total cost, $2,003,614

Project 2. Gene Mapping and the Search for Project 2. Gene Mapping and the Search for Candidate Genes: What gene groups are Candidate Genes: What gene groups are

involved in nicotine dependenceinvolved in nicotine dependence??

Kenneth Kendler, MD (PI)Kenneth Kendler, MD (PI)

Xiangning Chen, PhDXiangning Chen, PhD

GoalsGoals Identify genetic loci related to Identify genetic loci related to

adolescent tobacco use, through gene adolescent tobacco use, through gene association studiesassociation studies

Investigators have previously Investigators have previously identified chromosomal regions identified chromosomal regions associated with tobacco use in adultsassociated with tobacco use in adults

Are these same regions associated Are these same regions associated with smoking initiation and with smoking initiation and dependence in adolescents?dependence in adolescents?

Genome Scan of Adult SmokersGenome Scan of Adult Smokers

Progress in Genetic Mapping and Progress in Genetic Mapping and Candidate Gene ProjectCandidate Gene Project

Completed analysis of about 2/3 of Completed analysis of about 2/3 of chromosomal data from samples of chromosomal data from samples of adolescents in Christchurch, New Zealand adolescents in Christchurch, New Zealand and Richmond, Virginiaand Richmond, Virginia

Identified several candidate genes that may Identified several candidate genes that may be involved in susceptibility to tobacco-use be involved in susceptibility to tobacco-use initiation and nicotine dependency initiation and nicotine dependency

Established collaboration with researchers Established collaboration with researchers in pharmacology to analyze candidate gene in pharmacology to analyze candidate gene expression in laboratory animalsexpression in laboratory animals

Project 3. Gene Expression in Project 3. Gene Expression in AdolescentsAdolescents

Billy Martin, PhD (PI)Billy Martin, PhD (PI)

Imad Damaj, PhDImad Damaj, PhD

Michael Miles, PhDMichael Miles, PhD

Jenny Wiley, PhDJenny Wiley, PhD

GoalGoal

Determine the mechanisms by which Determine the mechanisms by which gene expression influences gene expression influences adolescent susceptibility to nicotineadolescent susceptibility to nicotine

Nicotine Sensitivity, Dependence, Nicotine Sensitivity, Dependence, and Metabolism in Adolescent Miceand Metabolism in Adolescent Mice

Acute Acute SensitivitySensitivity

Acute Acute SensitivitySensitivity

Genetic InfluencesGenetic Influences

Tolerance & Tolerance & DependenceDependenceTolerance & Tolerance & DependenceDependence

Metabolism & Metabolism & PharmacokineticsPharmacokinetics

Metabolism & Metabolism & PharmacokineticsPharmacokinetics

Models for Acute Sensitivity Models for Acute Sensitivity to Nicotineto Nicotine

33H-Nicotine H-Nicotine Binding:Binding:

αα44ββ22 Subtype Subtype

33H-Nicotine H-Nicotine Binding:Binding:

αα44ββ22 Subtype Subtype

LocomotorLocomotor ActivityActivity

LocomotorLocomotor ActivityActivity AnalgesiaAnalgesiaAnalgesiaAnalgesia

SeizuresSeizuresSeizuresSeizures

Nicotinic AntagonistsNicotinic AntagonistsNicotinic AntagonistsNicotinic Antagonists

33H-MLA H-MLA Binding:Binding:

αα7 7 SubtypeSubtype

33H-MLA H-MLA Binding:Binding:

αα7 7 SubtypeSubtype

Body TemperatureBody TemperatureBody TemperatureBody Temperature

Anxiolytic EffectAnxiolytic EffectAnxiolytic EffectAnxiolytic Effect

In VitroIn VitroEffectsEffects

In VitroIn VitroEffectsEffects

In VivoIn VivoEffectsEffectsIn VivoIn VivoEffectsEffects

Assessing Nicotine Dependence LiabilityAssessing Nicotine Dependence Liability

PositivePositiveReinforcementReinforcement

PositivePositiveReinforcementReinforcement

ToleranceToleranceToleranceTolerance PhysicalPhysical DependenceDependence

PhysicalPhysical DependenceDependence

ConditionedConditionedPlace-Place-

PreferencePreference

ConditionedConditionedPlace-Place-

PreferencePreference

AcuteAcuteAcuteAcute ChroniChroniccChroniChronicc

Somatic & Somatic & Affective Affective

WithdrawalWithdrawalSignsSigns

Somatic & Somatic & Affective Affective

WithdrawalWithdrawalSignsSigns

Enzymes for Nicotine Metabolism Differ in Early Enzymes for Nicotine Metabolism Differ in Early Adolescent and Young Adult Mice –Adolescent and Young Adult Mice –Sensitivity to Nicotine is Likely Age DependentSensitivity to Nicotine is Likely Age Dependent

<35 day 56 day

EarlyAdolescent

Young Adult

Determining the Genetic andDetermining the Genetic andBio-behavioral Bases forBio-behavioral Bases forAdolescent Responses to NicotineAdolescent Responses to Nicotine

Collaboration between Projects 2 & 3: Collaboration between Projects 2 & 3: NIH Center Grant proposal now in NIH Center Grant proposal now in development to tie together human development to tie together human and animal researchand animal research

Quantitative Trait Loci (QTL) Quantitative Trait Loci (QTL) methodologymethodology

Search for genes that determine age Search for genes that determine age and stage differences in sensitivity, and stage differences in sensitivity, dependence, and metabolismdependence, and metabolism

Project 4. Preventing Initial Tobacco Project 4. Preventing Initial Tobacco Use from Progressing to Nicotine Use from Progressing to Nicotine DependencyDependency

Thomas Eissenberg, PhD (PI)Thomas Eissenberg, PhD (PI)

Deborah Haller, PhDDeborah Haller, PhD

Michelle Acosta, PhDMichelle Acosta, PhD

GoalsGoals Understand in detail the stages of youth Understand in detail the stages of youth

smoking behavior, through clinical smoking behavior, through clinical laboratory assessment of individual laboratory assessment of individual adolescents’ responses to smokingadolescents’ responses to smoking

Using clinical-assessment and follow-up Using clinical-assessment and follow-up interview data, test various interventions interview data, test various interventions for their effectiveness in preventing for their effectiveness in preventing adolescent progression to nicotine adolescent progression to nicotine dependencydependency

SubjectsSubjects

Adolescent smokers: 12-18 years Adolescent smokers: 12-18 years of ageof age Stage 3 (experimenting) smokers: users Stage 3 (experimenting) smokers: users

who report smoking more than 1 cigarette who report smoking more than 1 cigarette per month but less than 1 per dayper month but less than 1 per day

Stage 4 (regular) smokers: users who Stage 4 (regular) smokers: users who report smoking more than 1 but less than report smoking more than 1 but less than 10 cigarettes per day10 cigarettes per day

Clinical Assessment: Testing Clinical Assessment: Testing Adolescents’ Responses to SmokingAdolescents’ Responses to Smoking

Physiological measurements, before and Physiological measurements, before and after one cigaretteafter one cigarette heart rateheart rate breath CObreath CO saliva cotinine (nicotine metabolite)saliva cotinine (nicotine metabolite) saliva cortisol (stress hormone)saliva cortisol (stress hormone) puff topographypuff topography

Craving and withdrawal questionnaires, Craving and withdrawal questionnaires, before and after one cigarettebefore and after one cigarette

Clinical Intervention: Testing Various Clinical Intervention: Testing Various Means to Prevent Adolescents from Means to Prevent Adolescents from Progressing to DependencyProgressing to Dependency

Compare the success rates of different Compare the success rates of different intervention modes in preventing subjects’ intervention modes in preventing subjects’ stage progression after 1, 3, 6, 9, and 12 stage progression after 1, 3, 6, 9, and 12 monthsmonths

Intervention 1: Motivational interviews, Intervention 1: Motivational interviews, providing subjects with personalized providing subjects with personalized information and clinical-assessment information and clinical-assessment feedback on the consequences of smokingfeedback on the consequences of smoking

Intervention 2: Anti-tobacco video materialIntervention 2: Anti-tobacco video material Intervention 3: Anti-tobacco print materialIntervention 3: Anti-tobacco print material

Progress in Clinical Trials ProjectProgress in Clinical Trials Project

IRB approval of protocol has been IRB approval of protocol has been grantedgranted

Clinical assessments pilot testedClinical assessments pilot tested Interventions prepared and pilot Interventions prepared and pilot

testedtested Subject recruitment to begin in April Subject recruitment to begin in April

20032003

Project 5. Youth Tobacco Project 5. Youth Tobacco Evaluation Project (YTEP)Evaluation Project (YTEP)

Project Team:Project Team:

Ilene Speizer, Brian Smith, Diane Baer Wilson, Ilene Speizer, Brian Smith, Diane Baer Wilson, Melanie Bean, Karen Mitchell, Samy Uguy, Melanie Bean, Karen Mitchell, Samy Uguy, Panumas Panumas Assavarakpreecha, Assavarakpreecha, Ramesh Ramakrishnan, Joyce Ramesh Ramakrishnan, Joyce Phillips, and Elizabeth Fries (PI)Phillips, and Elizabeth Fries (PI)

Objectives of YTEPObjectives of YTEP

Design a comprehensive evaluation of the 109 Design a comprehensive evaluation of the 109 youth tobacco prevention programs funded by youth tobacco prevention programs funded by the Virginia Tobacco Settlement Foundation the Virginia Tobacco Settlement Foundation

Train grantees to implement appropriate Train grantees to implement appropriate evaluation components for their programsevaluation components for their programs

Provide evaluation assistance for granteesProvide evaluation assistance for grantees

Provide analysis and dissemination of findingsProvide analysis and dissemination of findings

Single session programs

Multiple session programs

Overall Evaluation DesignOverall Evaluation Design Process EvaluationProcess Evaluation

All programsAll programs Session logs – content and deliverySession logs – content and delivery Instructor survey – acceptability of Instructor survey – acceptability of

program to instructors and participantsprogram to instructors and participants Pre K – 3Pre K – 3rdrd grades: Parent survey – determine if grades: Parent survey – determine if

kids understood and discussed programkids understood and discussed program 44thth & 5 & 5thth grades: Brief participant survey – grades: Brief participant survey –

perspectives on content, delivery, and perspectives on content, delivery, and appropriatenessappropriateness

Parent and family programs: Participant surveyParent and family programs: Participant survey – – content, delivery, and appropriatenesscontent, delivery, and appropriateness

Overall Evaluation Design, cont.Overall Evaluation Design, cont. Outcome EvaluationOutcome Evaluation

66thth – 12 – 12thth grades (76 of 109 grantees doing grades (76 of 109 grantees doing outcome evaluation)outcome evaluation) Pre-test survey: obtain baseline tobacco usePre-test survey: obtain baseline tobacco use Post-test survey: examine changes between Post-test survey: examine changes between

pre- and post-testspre- and post-tests Parental notification prior to 1Parental notification prior to 1stst survey survey

No identifying information kept on recordNo identifying information kept on record Match pre- and post-tests with anonymous Match pre- and post-tests with anonymous

linking schemelinking scheme Participants complete survey and place in an Participants complete survey and place in an

envelope and seal envelopeenvelope and seal envelope

Design of Outcome EvaluationDesign of Outcome EvaluationGrades 6 to 12Grades 6 to 12

Pre-testPre-test Funded Funded ProgramProgram

Post-testPost-test 1-year 1-year Follow-upFollow-up

Note: Note: Given limitations of pre-post design, where ever possible we will collect 1 year Given limitations of pre-post design, where ever possible we will collect 1 year follow-up. All data are linked due to sampling/generalizability limitations. Grantees follow-up. All data are linked due to sampling/generalizability limitations. Grantees receiving multiple years of funding will also be followed for 2-6 years depending on the receiving multiple years of funding will also be followed for 2-6 years depending on the age of the child.age of the child.

Framework: Outcome Questionnaire Framework: Outcome Questionnaire DevelopmentDevelopment

SOCIO-DEMOGRAPHICSOCIO-DEMOGRAPHIC• AgeAge Low SESLow SES Developmental stageDevelopmental stage GenderGender

ENVIRONMENTALENVIRONMENTAL

AccessibilityAccessibility

• AdvertisingAdvertising

Parental use Parental use

Sibling use Sibling use

Parental Parental supervision and supervision and strictnessstrictness

Peer usePeer use

Social bondingSocial bonding

Normative Normative expectationsexpectations

PERSONALPERSONAL

Knowledge of Knowledge of consequencesconsequences• Functional meaningsFunctional meanings• Subjective expected Subjective expected utilityutility

Self esteemSelf esteem• Self efficacySelf efficacy• Self imageSelf image

PersonalityPersonality

Psychological well-Psychological well-beingbeing

BEHAVIORALBEHAVIORAL

Academic Academic achievementachievement• Participation in sport Participation in sport & healthy behaviors& healthy behaviors

Peer groupsPeer groups• Other adv. behaviors Other adv. behaviors (risk-taking)(risk-taking)

Behavioral skillsBehavioral skills

SMOKING STAGESMOKING STAGE

PreparatoryPreparatory

TryingTrying

ExperimentalExperimental

Regular UseRegular Use

AddictionAddiction

Framework: Outcome Questionnaire Framework: Outcome Questionnaire DevelopmentDevelopment

SOCIO-DEMOGRAPHICSOCIO-DEMOGRAPHIC• AgeAge Low SESLow SES Developmental stageDevelopmental stage GenderGender

ENVIRONMENTALENVIRONMENTAL

AccessibilityAccessibility

• AdvertisingAdvertising

Parental use Parental use

Sibling use Sibling use

Parental Parental supervision and supervision and strictnessstrictness

Peer usePeer use

Social bondingSocial bonding

Normative Normative expectationsexpectations

PERSONALPERSONAL

Knowledge of Knowledge of consequencesconsequences• Functional meaningsFunctional meanings• Subjective expected Subjective expected utilityutility

Self esteemSelf esteem• Self efficacySelf efficacy• Self imageSelf image

PersonalityPersonality

Psychological well-Psychological well-beingbeing

BEHAVIORALBEHAVIORAL

Academic Academic achievementachievement• Participation in sport Participation in sport & healthy behaviors& healthy behaviors

Peer groupsPeer groups• Other adv. behaviors Other adv. behaviors (risk-taking)(risk-taking)

Behavioral skillsBehavioral skills

SMOKING STAGESMOKING STAGE

PreparatoryPreparatory

TryingTrying

ExperimentalExperimental

Regular UseRegular Use

AddictionAddiction

Preparing for Drug Preparing for Drug Free YearsFree Years

Strengthening FamiliesStrengthening FamiliesSkills for adolescents Skills for adolescents

Here’s Looking at YouHere’s Looking at YouSMART LeadersSMART LeadersToo Good for DrugsToo Good for Drugs

Life Skills TrainingLife Skills TrainingTar WarsTar WarsTeens Against Tobacco Teens Against Tobacco UseUseGet Real About Tobacco Get Real About Tobacco Here’s Looking at YouHere’s Looking at YouSMART LeadersSMART LeadersAl’s PalsAl’s PalsSmoggy and ClaireSmoggy and ClaireMedia Sharp Media Sharp Anti Tobacco Media BlitzAnti Tobacco Media BlitzToo Good for DrugsToo Good for DrugsSmoke Free, That’s MeSmoke Free, That’s Me

Life Skills TrainingLife Skills Training

Too Good for DrugsToo Good for Drugs

Teens Against Tobacco Teens Against Tobacco UseUse

Positive ActionPositive ActionNOT (w/ smokers)NOT (w/ smokers)Get Real About TobaccoGet Real About Tobacco

NOTNOTENDEND

Characteristics of Baseline Characteristics of Baseline Sample (N=10,008)Sample (N=10,008)

Distribution of sample by gender

Female51%

Male49%

Distribution of sample by grade

8th

9th

10th

11th12th

6th

7th



Distribution of sample by race/ethnicity

73%

21%

2%

1%

3%

White

Black

Hispanic

Asian or PacificIslander

American Indianor Alaskan Native

Number of Agencies with Number of Agencies with Participating Youth, by RegionParticipating Youth, by Region

Number of agencies with participating youth by region

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Region

Nu

mb

er

of

Ag

en

cie

s

Series1

Compendium ProgramsCompendium Programs

Number of organizations implementing each compendium program (among programs with

50+ youth surveyed)

0

1

2

3

4

5

6

7

8

9

Compendium Program

Nu

mb

er o

f O

rgan

izat

ion

s

Smoking Experience and UseSmoking Experience and Use

Smoking experience and use among youth, by grade

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

6th 7th 8th 9th 10th 11th 12th

Grade

Perc

enta

ge

Never smoked Ever smoked, not current Current smoker (in last 30 days)

Smokeless Tobacco Use among Smokeless Tobacco Use among Male YouthMale Youth

Smokeless tobacco experience and use among male youth, by grade

0%10%20%30%40%50%60%70%80%90%

100%

6th 7th 8th 9th 10th 11th 12th

Grade

Perc

en

tag

e

Never used Ever used, not current Current user (in last 30 days)

Upcoming ActivitiesUpcoming Activities Collect, clean, and code post-test dataCollect, clean, and code post-test data

Complete coding of process evaluation dataComplete coding of process evaluation data

Evaluate the first round of funding by Evaluate the first round of funding by comparing pre-test to post-test results as comparing pre-test to post-test results as they relate to program exposurethey relate to program exposure

Disseminate results, to VTSF affiliates, and Disseminate results, to VTSF affiliates, and to the research and evaluation communityto the research and evaluation community


COALITION BUILDINGCOALITION BUILDING

Robert L. Balster, Robert L. Balster, PhDPhD

Future Directions Future Directions for the VYTP Coalitionfor the VYTP Coalition

Statewide Conference on Addiction Statewide Conference on Addiction and Youthand Youth Bring in national leaders in addiction and Bring in national leaders in addiction and

prevention researchprevention research

Invite presentations from Virginia Invite presentations from Virginia participantsparticipants

Arrange suitable public and media Arrange suitable public and media participationparticipation

Future Directions Future Directions for the VYTP Coalitionfor the VYTP Coalition

Expand exchange visits among coalition members, Expand exchange visits among coalition members, and promote other collaborative activitiesand promote other collaborative activities

Identify and fund other components from the Identify and fund other components from the subcontracts (e.g. William and Mary)subcontracts (e.g. William and Mary)

Facilitate direct VTSF applications for coalition Facilitate direct VTSF applications for coalition membersmembers

Small Grants ProgramSmall Grants Program

Faculty Scholars ProgramFaculty Scholars Program Existing facultyExisting faculty

Mentoring componentMentoring component

The VYTP VisionThe VYTP Vision Building a first-class, tobacco-research Building a first-class, tobacco-research

“ “Institute without Walls” at Virginia universitiesInstitute without Walls” at Virginia universities

What are the requirements to realize this vision?What are the requirements to realize this vision?

Continuing, multiyear funding commitments from Continuing, multiyear funding commitments from Virginia’s master settlement agreementVirginia’s master settlement agreement

Strategic partnerships among VPs for Research at Strategic partnerships among VPs for Research at Virginia schools, making tobacco research a priorityVirginia schools, making tobacco research a priority

Concerted efforts among our faculty, both within and Concerted efforts among our faculty, both within and between institutions, to collaborate on research and between institutions, to collaborate on research and grant-seekinggrant-seeking

Creative trans-disciplinary thinking and action, to Creative trans-disciplinary thinking and action, to translate the findings of basic and applied science into translate the findings of basic and applied science into improved tobacco-use prevention programsimproved tobacco-use prevention programs


Securing the health Securing the health

of Virginia’s youth of Virginia’s youth

through sciencethrough science

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations

Breland, A.B., Acosta M.C., and Eissenberg, T. (submitted Breland, A.B., Acosta M.C., and Eissenberg, T. (submitted for publication) Tobacco-Specific Nitrosamines and for publication) Tobacco-Specific Nitrosamines and Potential Reduced Exposure Products for Smokers: A Potential Reduced Exposure Products for Smokers: A Preliminary Evaluation of Advance™. Preliminary Evaluation of Advance™.

Breland, A.B., Buchhalter, A.R., Evans, S.E., and Breland, A.B., Buchhalter, A.R., Evans, S.E., and Eissenberg, T. (2002) Evaluating acute effects of Eissenberg, T. (2002) Evaluating acute effects of potential reduced exposure products for smokers: clinical potential reduced exposure products for smokers: clinical laboratory methodology. laboratory methodology. Nicotine and Tobacco Nicotine and Tobacco ResearchResearch. 4 (Suppl 2): S131-S140.. 4 (Suppl 2): S131-S140.

Breland, A.B., Evans, S.E., Buchhalter, A.R., and Breland, A.B., Evans, S.E., Buchhalter, A.R., and Eissenberg, T. (2002) Acute effects of AdvanceTM: a Eissenberg, T. (2002) Acute effects of AdvanceTM: a potential reduced exposure product for smokers. potential reduced exposure product for smokers. Tobacco ControlTobacco Control. 11:376-378.. 11:376-378.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Carroll, F.I., Lee, J.R., Navarro, H.A., Brieaddy, L.E., Carroll, F.I., Lee, J.R., Navarro, H.A., Brieaddy, L.E.,

Abraham, P., Damaj, M.I., and Martin, B.R.: Nicotinic Abraham, P., Damaj, M.I., and Martin, B.R.: Nicotinic acetylcholine receptor binding, and antinociceptive acetylcholine receptor binding, and antinociceptive properties of 2-exo-2-(2’-substituted-3’-phenyl-5’-properties of 2-exo-2-(2’-substituted-3’-phenyl-5’-pyridinyl)-7-azabicyclo[2.2.1]heptanes. Society for pyridinyl)-7-azabicyclo[2.2.1]heptanes. Society for Research on Nicotine and Tobacco, Savannah, GA, 2002.Research on Nicotine and Tobacco, Savannah, GA, 2002.

Carroll, F.I., Lee, J.R., Navarro, H.A., Ma, W., Brieaddy, Carroll, F.I., Lee, J.R., Navarro, H.A., Ma, W., Brieaddy, L.E., Abraham, P., Damaj, M.I. and Martin, B.R. (2002) L.E., Abraham, P., Damaj, M.I. and Martin, B.R. (2002) Synthesis, nicotinic acetylcholine receptor binding, and Synthesis, nicotinic acetylcholine receptor binding, and antinociceptive properties of 2-exo-2-(2',3'-disubstituted antinociceptive properties of 2-exo-2-(2',3'-disubstituted 5'- pyridinyl)-7-azabicyclo[2.2.1]heptanes: epibatidine 5'- pyridinyl)-7-azabicyclo[2.2.1]heptanes: epibatidine analogues. analogues. J Med ChemJ Med Chem 45:4755-4761. 45:4755-4761.

Damaj, M.I. Activation of neuronal calcium calmoduline-Damaj, M.I. Activation of neuronal calcium calmoduline-kinase II after acute nicotine: behavioral and genetic kinase II after acute nicotine: behavioral and genetic approaches. Society of Neurosciences, Orlando, Fl, 2002.approaches. Society of Neurosciences, Orlando, Fl, 2002.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Damaj, M.I. Neurobiology of nicotine dependence. Damaj, M.I. Neurobiology of nicotine dependence.

Society for Research on Nicotine and Tobacco, Society for Research on Nicotine and Tobacco, Savannah, GA, 2002.Savannah, GA, 2002.

Damaj, M.I. and Martin, B.R. Effects of nicotine and Damaj, M.I. and Martin, B.R. Effects of nicotine and nicotinic agonists in a neuropathic pain model. World nicotinic agonists in a neuropathic pain model. World Congress on Pain, San Diego, CA, 2002Congress on Pain, San Diego, CA, 2002

Damaj, M.I. and Martin, B.R. Differential involvement of Damaj, M.I. and Martin, B.R. Differential involvement of calcium calmoduline-kinase II in nicotine’s calcium calmoduline-kinase II in nicotine’s pharmacological effects in mice. College on Problems of pharmacological effects in mice. College on Problems of Drug Dependence, June, 2002. Drug Dependence, June, 2002.

Damaj, M.I. and Martin, B.R. Effect of (-)-menthol on Damaj, M.I. and Martin, B.R. Effect of (-)-menthol on nicotine’s pharmacological effects in mice. Conference nicotine’s pharmacological effects in mice. Conference on Menthol Cigarettes, Atlanta, GA, 2002.on Menthol Cigarettes, Atlanta, GA, 2002.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations

Dukat, M., Damaj, I.M., Young, R., Vann, R., Collins, A.C., Dukat, M., Damaj, I.M., Young, R., Vann, R., Collins, A.C., Marks, M.J., Martin, B.R. and Glennon, R.A. (2002) Marks, M.J., Martin, B.R. and Glennon, R.A. (2002) Functional diversity among 5-substituted nicotine Functional diversity among 5-substituted nicotine analogs; in vitro and in vivo investigations. analogs; in vitro and in vivo investigations. Eur J Eur J PharmacolPharmacol 435:171-180. 435:171-180.

Dukat, M., El-Zahabi, M., Ferretti, G., Damaj, M.I., Martin, Dukat, M., El-Zahabi, M., Ferretti, G., Damaj, M.I., Martin, B.R., Young, R. and Glennon, R.A. (2002) (-)6-n-B.R., Young, R. and Glennon, R.A. (2002) (-)6-n-Propylnicotine antagonizes the antinociceptive effects of Propylnicotine antagonizes the antinociceptive effects of (-)nicotine. (-)nicotine. Bioorg Med Chem LettBioorg Med Chem Lett 12:3005-3007. 12:3005-3007.

Eissenberg, T. (submitted for publication) Measuring the Eissenberg, T. (submitted for publication) Measuring the emergence of tobacco dependence: the contribution of emergence of tobacco dependence: the contribution of negative reinforcement models.negative reinforcement models.

Eissenberg, T. (2002). Progress in nicotine and tobacco Eissenberg, T. (2002). Progress in nicotine and tobacco research. research. Nicotine and Tobacco ResearchNicotine and Tobacco Research. 4:355-362.. 4:355-362.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Eissenberg, T., and Balster, R.L. (2000). Initial tobacco Eissenberg, T., and Balster, R.L. (2000). Initial tobacco

use episodes in adolescents: current knowledge, future use episodes in adolescents: current knowledge, future directions. directions. Drug and Alcohol Dependence.Drug and Alcohol Dependence. 59 (Suppl 59 (Suppl 1):S41-S60.1):S41-S60.

Ferretti, G., Dukat, M., Giannella, M., Piergentili, A., Ferretti, G., Dukat, M., Giannella, M., Piergentili, A., Pigini, M., Quaglia, W., Damaj, M.I., Martin, B.R. and Pigini, M., Quaglia, W., Damaj, M.I., Martin, B.R. and Glennon, R.A. (2002) Homoazanicotine: a structure-Glennon, R.A. (2002) Homoazanicotine: a structure-affinity study for nicotinic acetylcholine (nACh) receptor affinity study for nicotinic acetylcholine (nACh) receptor binding. binding. J Med ChemJ Med Chem 45:4724-4731. 45:4724-4731.

Fonck, C., Nashmi, R., Deshpande, P., Damaj, M. I., Fonck, C., Nashmi, R., Deshpande, P., Damaj, M. I., Marks, M. J., Schwarz, J., Collins, A. C., Labarca, C., and Marks, M. J., Schwarz, J., Collins, A. C., Labarca, C., and Lester, H.A. (in press). Increased sensitivity to agonist-Lester, H.A. (in press). Increased sensitivity to agonist-induced seizures, Straub Tail, and hippocampal theta induced seizures, Straub Tail, and hippocampal theta rhythm, in knock-in mice carrying hypersensitiverhythm, in knock-in mice carrying hypersensitive α α4 4 nicotinic receptors. nicotinic receptors. J NeurosciJ Neurosci, 2003., 2003.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Haller, D.L., Miles, D.R., and Cropsey, K.L. (submitted for Haller, D.L., Miles, D.R., and Cropsey, K.L. (submitted for

publication) Smoking Stage of Change Influences publication) Smoking Stage of Change Influences Retention in Smoke-Free Residential Treatment Program Retention in Smoke-Free Residential Treatment Program for Women. for Women.

Hamilton, D.C.P., Acosta, M., Buchhalter, A.R., and Hamilton, D.C.P., Acosta, M., Buchhalter, A.R., and Eissenberg, T. Urine Cotinine as an Index of Smoking Eissenberg, T. Urine Cotinine as an Index of Smoking Status: Comparison of GC/MS with Immunoassay Test Status: Comparison of GC/MS with Immunoassay Test Strips. Society for Research on Nicotine and Tobacco, Strips. Society for Research on Nicotine and Tobacco, February 2003.February 2003.

Houtsmuller, E.J., Fant, R.V., Eissenberg, T., Henningfield, Houtsmuller, E.J., Fant, R.V., Eissenberg, T., Henningfield, J.E., and Stitzer M.L. (2002). Flavor improvement does J.E., and Stitzer M.L. (2002). Flavor improvement does not increase abuse liability of nicotine chewing gum. not increase abuse liability of nicotine chewing gum. Pharmacology, Biochemistry, and BehaviorPharmacology, Biochemistry, and Behavior. 72:559-568.. 72:559-568.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Lanni, S.M., Jansson, L., Miles, D.R., Raiford, K. and Lanni, S.M., Jansson, L., Miles, D.R., Raiford, K. and

Svikis, D.S. Impact of perinatal tobacco and drug use on Svikis, D.S. Impact of perinatal tobacco and drug use on neonatal outcomes. Society of Maternal Fetal Medicine, neonatal outcomes. Society of Maternal Fetal Medicine, New Orleans, LA, January 2002.New Orleans, LA, January 2002.

Lee, M., Dukat, M., Liao, L., Flammia, D., Damaj, M.I., Lee, M., Dukat, M., Liao, L., Flammia, D., Damaj, M.I., Martin, B.R. and Glennon, R.A. (2002) A comparison of Martin, B.R. and Glennon, R.A. (2002) A comparison of the binding of three series of nicotinic ligands. the binding of three series of nicotinic ligands. Bioorg Bioorg Med Chem LettMed Chem Lett 12:1989-1992. 12:1989-1992.

Martin, B.R., Lukas, R.J., Eaton, B., Carroll, F.I., Navarro, Martin, B.R., Lukas, R.J., Eaton, B., Carroll, F.I., Navarro, H.A., and Damaj, M.I. Evidence that bupropion’s H.A., and Damaj, M.I. Evidence that bupropion’s pharmacological effects are primarily mediated via pharmacological effects are primarily mediated via conversion to its 2S,3S-hydroxy metabolite. Society for conversion to its 2S,3S-hydroxy metabolite. Society for Research on Nicotine and Tobacco, February, 2003.Research on Nicotine and Tobacco, February, 2003.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Maziak, W., Eissenberg, T., Klesges, R.C., Kiel, U., and Maziak, W., Eissenberg, T., Klesges, R.C., Kiel, U., and

Ward, K.D. (submitted for publication) Adapting Smoking Ward, K.D. (submitted for publication) Adapting Smoking Cessation Interventions for Developing Countries: A Cessation Interventions for Developing Countries: A Model for the Middle East.Model for the Middle East.

Miles, D.R., Silberg, J.L., Maes, H.H., and Eaves, L.J. Miles, D.R., Silberg, J.L., Maes, H.H., and Eaves, L.J. Testing for effects of genes, environment, and gender in Testing for effects of genes, environment, and gender in tobacco initiation and continuation in adolescents: A tobacco initiation and continuation in adolescents: A Markov Chain Monte Carlo Approach. College on Markov Chain Monte Carlo Approach. College on Problems of Drug Dependence, Bal Harbour, FL, June Problems of Drug Dependence, Bal Harbour, FL, June 2003.2003.

Miles, D.R., Silberg, J.L., Pickens, R.W., and Eaves, L.J. Miles, D.R., Silberg, J.L., Pickens, R.W., and Eaves, L.J. Gender differences in genetic and environmental risk Gender differences in genetic and environmental risk factors for adolescent tobacco, alcohol and illicit drug factors for adolescent tobacco, alcohol and illicit drug use (2002). use (2002). Drug and Alcohol DependenceDrug and Alcohol Dependence, 66:S120., 66:S120.

Recent VCU Tobacco-Research Recent VCU Tobacco-Research Publications and PresentationsPublications and Presentations Pickens, R.W., Balster, R.L. and White, M. International Pickens, R.W., Balster, R.L. and White, M. International

Symposium on Nicotine and Tobacco Research, Symposium on Nicotine and Tobacco Research, Santander, Spain, October 4, 2002.Santander, Spain, October 4, 2002.

Sellers, E.M., Ibekwe, A., Martin, B.R., Glassco, W., Sellers, E.M., Ibekwe, A., Martin, B.R., Glassco, W., Damaj, M.I., and Tyndale, R.F.: In vitro identification of Damaj, M.I., and Tyndale, R.F.: In vitro identification of nicotine analogs as CYP2A6 inbitiros and substrates. nicotine analogs as CYP2A6 inbitiros and substrates. Society for Research on Nicotine and Tobacco. Society for Research on Nicotine and Tobacco. Savannah, GA, 2002.Savannah, GA, 2002.

Wiley, J.L., Lavecchia, K.L., Martin, B.R. and Damaj, M.I. Wiley, J.L., Lavecchia, K.L., Martin, B.R. and Damaj, M.I. (2002) Nicotine-like discriminative stimulus effects of (2002) Nicotine-like discriminative stimulus effects of bupropion in rats. bupropion in rats. Exp Clin PsychopharmacolExp Clin Psychopharmacol 10:129-135. 10:129-135.

Zack, M., Belsito, L., Scher, R., Zack, M., Belsito, L., Scher, R., Eissenberg, T., and Eissenberg, T., and Corrigall, W.A. (2001) Corrigall, W.A. (2001) Effects of abstinence and smoking Effects of abstinence and smoking on information processing in adolescent smokers. on information processing in adolescent smokers. PsychopharmacologyPsychopharmacology. 153:249-257. . 153:249-257.

Documents

VYTP Virginia Youth Tobacco Project