哮喘联盟

    背景：许多吸烟者想通过逐渐减少吸烟量直至完全停止吸烟而实现戒烟。本研究检测了尼古丁口香糖在通过逐渐减少吸烟量实现戒烟中的促进作用。
    试验设计：本研究为多中心、安慰剂对照、双盲、2 mg和4 mg尼古丁口香糖与安慰剂的随机对照试验（RCT）。
    研究背景/研究对象：3297名对通过逐渐减少吸烟量而实现戒烟感兴趣的吸烟者。
    干预措施：在8周的时间内，研究对象在指导下逐渐减少吸烟量，同时增加口香糖的使用量。一旦研究对象实现初期戒烟，即24小时内没有吸烟，就按照目前FDA批准的戒烟方针使用口香糖。本研究在无医生处方的条件下进行，不提供咨询服务。28天和6个月后评估是否持续戒烟，并评估减少吸烟量的次要测量指标。于1999～2000年和2007～2008年进行分析。
    主要检测项目：使用口香糖的吸烟者更可能实现初期戒烟（2 mg尼古丁口香糖: OR=1.42; 4 mg尼古丁口香糖: OR=1.90）、28天持续戒烟（2 mg尼古丁口香糖: OR=2.01; 4 mg尼古丁口香糖: OR=4.66）和6个月持续戒烟（2 mg尼古丁口香糖: OR=1.80; 4 mg尼古丁口香糖: OR=5.96）。在减少吸烟量期间，主动使用口香糖辅以减少吸烟量，吸烟量减少的研究对象更可能实现戒烟。
    结论：这些研究结果证实想要通过逐渐减少吸烟量实现戒烟的吸烟者可通过使用尼古丁口香糖促进减少吸烟量和实现戒烟。

（刘国梁 审校）
Shiffman S, et al. Am J Prev Med. 2009 Feb;36(2):96-104.e1.

Quitting by gradual smoking reduction using nicotine gum: a randomized controlled trial.

BACKGROUND: Many smokers express a desire to quit smoking by gradually reducing the number of cigarettes they smoke until they stop completely. This study tested the efficacy of nicotine gum in facilitating cessation through gradual reduction.
DESIGN: This was a multi-center, placebo-controlled, double-blind RCT of 2- and 4-mg nicotine gum versus placebo.
SETTING/PARTICIPANTS: 3297 smokers who were interested in quitting gradually. INTERVENTION: Subjects were instructed to gradually reduce their smoking while increasing their gum use over the course of up to 8 weeks. Once they had achieved initial abstinence (no smoking for 24 hours), gum was to be used in accordance with the current FDA-approved directions for cessation. The study was conducted under over-the-counter conditions, with no counseling provided. Continuous abstinence was assessed after 28 days and 6 months. Secondary measures of smoking reduction were also assessed. Analyses were conducted in 1999-2000 and 2007-2008.
MAIN OUTCOME MEASURES: Smokers on active gum were significantly more likely to achieve initial cessation (2 mg: OR=1.42; 4 mg: OR=1.90); 28-day continuous abstinence (2 mg: OR=2.01; 4 mg: OR=4.66); and continuous abstinence at 6 months (2 mg: OR=1.80; 4 mg: OR=5.96). During the reduction phase, active gum aided smoking reduction, and participants who reduced their smoking were more likely to achieve abstinence.
CONCLUSIONS: These findings demonstrate that smokers who wish to quit smoking by gradual reduction can increase their success by using nicotine gum to facilitate reduction and cessation.