# Understanding the Role of Cognitive Dysfunction in the Treatment of Nicotine Dependence among HIV-Infected Smokers

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $642,213

## Abstract

PROJECT SUMMARY
Medical advances in the treatment of HIV/AIDS have significantly improved the life expectancy and quality of
life of HIV-infected individuals. However, complications arising from HIV-1 infection, including cardiovascular
disease and , can reduce the efficacy of anti-retroviral
medications (HAART), reduce HAART adherence, and decrease quality of life among HIV-infected individuals.
Thus, addressing modifiable risk factors, such as tobacco use, has become a critical priority. Unfortunately,
HIV-infected individuals are three times more likely to use tobacco than those in the general population, but
little is known about the mechanisms that underlie these high smoking rates. One plausible mechanism is that
the cognitive enhancing effects of nicotine ameliorate neurocognitive deficits associated with HIV-1 infection.
HIV-associated neurocognitive disorders (HANDs)
In
the general population, acute nicotine withdrawal (i.e., 24 to 72 hours following cessation) produces deficits in
cognitive function that, in turn, predict smoking relapse. This will be the first study to test whether t
he
neurocognitive impairments associated with HIV-1 infection may be exacerbated during nicotine withdrawal
and increase the probability of smoking relapse among HIV-infected smokers (HIV+), compared to HIV-
uninfected smokers (HIV-). Specifically, we hypothesize that: (1) HIV+ smokers (vs. HIV- smokers) are more
likely to experience cognitive deficits during nicotine abstinence; (2) HIV+ smokers (vs. HIV- smokers) are
more likely to relapse to smoking following standard treatment; and (3) abstinence-induced cognitive deficits
will predict relapse and will mediate the association of HIV status with relapse. To this end, adult treatment-
seeking smokers (N=300; 150 HIV+ and 150 HIV-) will complete this 12-week study, which is divided into two
phases: a pre-quit laboratory phase (weeks 0-2) and a treatment phase (weeks 3-12). Subjects will complete
two laboratory sessions during the pre-quit phase: once following 24 hours of mandatory smoking abstinence
and once while smoking-as-usual (order counterbalanced). A comprehensive cognitive task battery assessing
memory, attention, and executive function will be administered during each laboratory session. During the
treatment phase, all subjects will receive standard smoking cessation treatment, including counseling (weeks
3-8) and open-label transdermal nicotine (TN) patches (weeks 4-12). The primary outcomes are: 1) cognitive
performance following 24-hours smoking abstinence (vs. smoking-as-usual) during the pre-quit phase; and 2)
7-day point-prevalence, biochemically-confirmed abstinence rates at the end-of-treatment (EOT) for the
treatment phase. Our study design bridges the gap between laboratory and treatment studies by including a
rigorous test of mechanisms associated with relapse. Characterizing cognitive deficits during early nicotine
withdrawal that are unique to HIV+ smokers and that predict relapse m...

## Key facts

- **NIH application ID:** 9963171
- **Project number:** 5R01DA042682-05
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Rebecca Ashare
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $642,213
- **Award type:** 5
- **Project period:** 2016-08-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9963171

## Citation

> US National Institutes of Health, RePORTER application 9963171, Understanding the Role of Cognitive Dysfunction in the Treatment of Nicotine Dependence among HIV-Infected Smokers (5R01DA042682-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9963171. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*