Mark Zakrajsek, a Class of 2023 medical student at the Wayne State University School of Medicine, is exploring how stress affects delay discounting in cigarette smokers in a research collaboration with two faculty members.

They include Associate Professors of Psychiatry and Behavioral Neurosciences David Ledgerwood, Ph.D., and Leslie Lundahl, Ph.D., L.P.

The Nicotine and Tobacco Research Division, or NTRD, based in the Tolan Park Medical Building, provides Wayne State researchers with a hub to enhance research communication, collaboration and educational opportunities with the ultimate goal of advancing science and enhancing the lives of tobacco users in the region.

Associate Professor of Psychiatry and Behavioral Sciences David Ledgerwood, Ph.D., serves as director of the division. Dr. Ledgerwood, a clinical psychologist, has conducted research on smoking cessation intervention with support from the National Institutes of Health.

The idea behind delay discounting is that a person will discount the value of future rewards in exchange for a more immediate lesser reward.

“When applying this to smoking, it is thought that a person with nicotine dependence may overvalue the small immediate reward of smoking a cigarette instead of refusing to smoke to achieve the much greater reward of overcoming their nicotine dependence,” Zakrajsek said. “In particular, we are looking at whether acute stress will increase delay discounting in people with nicotine dependence compared to individuals who also have nicotine dependence but are not experiencing acute stress.”

More than 15 percent of adults in the United States smoke cigarettes, causing an estimated $300 billion in direct health care costs and lost productivity yearly, Dr. Ledgerwood said.

Stress is believed to be one of the greatest hurdles for nicotine-dependent individuals in their efforts to quit smoking, “so this pilot study is what we hope will be the first step in better understanding just how stress impacts a person’s urge to smoke,” Zakrajsek said.

They are in the planning stages of the study.

Zakrajsek graduated from Xavier University in 2017, then worked as a clinical research coordinator at Cincinnati Children’s Hospital Department of Emergency Medicine, where he counseled parents who were daily cigarette smokers and following up with those families on home visits over six months.

“I really enjoyed getting to know these families and knew I wanted to continue working with and helping people affected by nicotine dependence as a medical student at Wayne State."

He reached out to Dr. Ledgerwood in his first year, after reading about the new Nicotine and Tobacco Research Division he started in 2019.

“The Delay Discounting Study was something that strongly aligned with my research interests and passions as a future physician, so I immediately agreed to work with him on it. I’m grateful for the opportunity to have Dr. Ledgerwood as a mentor, because of his extensive work helping people struggling with substance use disorders, and I'm very excited for what the future holds with the Nicotine and Tobacco Research Division,” Zakrajsek said.