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An Adolescent Substance Prevention Model Blocks the Effect of CHRNA5 Genotype on Smoking During High School.

ABSTRACT: Prevention intervention programs reduce substance use, including smoking, but not all individuals respond. We tested whether response to a substance use prevention/intervention program varies based upon a set of five markers (rs16969968, rs1948, rs578776, rs588765, and rs684513) within the cluster of nicotinic acetylcholine receptor subunit genes (CHRNA5/A3/B4).Participants (N = 424) were randomly assigned to either control condition, or a family-based intervention in grade 6 and a school-based drug preventive intervention in grade 7. Smoking in the past month was assessed in grades 9-12 using a four-point scale (0 = never smoked, 1 = smoked but not in last month, 2 = one or a few times, 3 = about once a week or more).There was a main effect of both the intervention (b = -0.24, P < .05) and genotype at rs16969968 (b = 0.14, P < .05) on high school smoking. Using dummy coding to allow for nonlinear effects, individuals with the A/A genotype smoked more often than those with G/G (b = 0.33, P < .05). A genotype × intervention effect was found with reduced smoking among those with A/A and G/A genotypes to levels similar to those with the G/G genotype (G/G vs. A/A: b = -0.67, P < .05; A/G vs. A/A: b = -0.61, P < .05; G/G vs. A/G ns). Results were nonsignificant for the other four markers.Preventive interventions can reduce the genetic risk for smoking from rs16969968.

SUBMITTER: Vandenbergh DJ

PROVIDER: S-EPMC4723675 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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An Adolescent Substance Prevention Model Blocks the Effect of CHRNA5 Genotype on Smoking During High School.

Vandenbergh David J DJ Schlomer Gabriel L GL Cleveland H Harrington HH Schink Alisa E AE Hair Kerry L KL Feinberg Mark E ME Neiderhiser Jenae M JM Greenberg Mark T MT Spoth Richard L RL Redmond Cleve C

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 20150504 2

<h4>Introduction</h4>Prevention intervention programs reduce substance use, including smoking, but not all individuals respond. We tested whether response to a substance use prevention/intervention program varies based upon a set of five markers (rs16969968, rs1948, rs578776, rs588765, and rs684513) within the cluster of nicotinic acetylcholine receptor subunit genes (CHRNA5/A3/B4).<h4>Methods</h4>Participants (N = 424) were randomly assigned to either control condition, or a family-based interv ...[more]

PMID: 25941207

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Project description:Implementation fidelity describes how well an intervention is implemented in the real-world setting. Assessing implementation fidelity is essential in the understanding of intervention results. In most studies, implementation fidelity is measured insufficiently, though, not taking into account the complexity of the concept nor the intervention. The objective of the present study was to develop an overall quantitative measure of implementation fidelity, to examine the degree of implementation fidelity and the association of implementation and effect of a randomized school-based smoking prevention trial-the X:IT study.A cluster-randomized trial testing is a multi-component intervention to prevent smoking among adolescents in 94 Danish elementary schools (51 intervention, 43 control schools). Participants were grade 7 pupils (mean age 12.5 years). Data was collected by electronic questionnaires among pupils at baseline (n = 4161), the first follow-up (n = 3764), and the second follow-up (n = 3269) and among school coordinators at intervention schools at the first and second follow-up (50 and 39 coordinators).The intervention included three components: (1) smoke-free school grounds, (2) smoke-free curriculum, and (3) parental involvement, contracts, and dialogues. Implementation fidelity was assessed by four domains: adherence, dose, quality of delivery, and participant responsiveness. These were combined into an overall school-wise implementation index. The association of implementation and smoking was examined by logistic regression analyses.One fourth of the schools was characterized as high implementers of the program (all three components) at both first (12 schools, 24.0 %) and second follow-up (11 schools, 28.2 %). Implementation fidelity was strongly associated with smoking at the first and second follow-up, e.g., the odds for smoking at schools with high implementation both years were OR = 0.44 (95 % CI 0.32 to 0.68).Using an overall measure based on several aspects of implementation fidelity, we showed a negative graded association between implementation and smoking. This study suggests that higher degrees of implementation will improve the effect of the X:IT intervention. Studying the association between implementation and effect is extremely important; only by doing so, we can distinguish the quality of the intervention from the success of the implementation.Current Controlled Trials ISRCTN77415416.

Project description:BackgroundEvidence suggests that aspects of the neighborhood environment may influence risk of problematic drug use among adolescents. Our objective was to examine mediating roles of aspects of the school and peer environments on the effect of receiving a Section 8 housing voucher and using it to move out of public housing on adolescent substance use outcomes.MethodsWe used data from the Moving to Opportunity (MTO) experiment that randomized receipt of a Section 8 housing voucher. Hypothesized mediators included school climate, safety, peer drug use, and participation in an after-school sport or club. We applied a doubly robust, semiparametric estimator to longitudinal MTO data to estimate stochastic direct and indirect effects of randomization on cigarette use, marijuana use, and problematic drug use. Stochastic direct and indirect effects differ from natural direct and indirect effects in that they do not require assuming no posttreatment confounder of the mediator-outcome relationship. Such an assumption would be at odds with any causal model that reflects an intervention affecting a mediator and outcome through adherence to treatment assignment.ResultsHaving friends who use drugs and involvement in after-school sports or clubs partially mediated the effect of housing voucher receipt on adolescent substance use (e.g., stochastic indirect effect 0.45% [95% confidence interval: 0.12%, 0.79%] for having friends who use drugs and 0.04% [95% confidence interval: -0.02%, 0.10%] for involvement in after-school sports or clubs mediating the relationship between housing voucher receipt and marijuana use among boys). However, these mediating effects were small, contributing only fractions of a percent to the effect of voucher receipt on probability of substance use. No school environment variables were mediators.ConclusionsMeasured school- and peer-environment variables played little role in mediating the effect of housing voucher receipt on subsequent adolescent substance use.

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An Adolescent Substance Prevention Model Blocks the Effect of CHRNA5 Genotype on Smoking During High School.

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An Adolescent Substance Prevention Model Blocks the Effect of CHRNA5 Genotype on Smoking During High School.

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