酒精治疗期间戒烟：联合使用尼古丁贴剂和尼古丁口香糖的随机试验
2009/10/15
目的：该研究的主要目的为在早期酒精治疗的门诊患者中比较联合尼古丁贴剂和尼古丁口香糖与联合尼古丁贴剂和安慰剂在治疗酒精依赖性吸烟者中的疗效。次要目的为评估联合应用尼古丁替代治疗对饮酒是否有滞留效应。
设计：为期1年的小样本、随机、双盲、安慰剂－对照的临床试验，评价吸烟和饮酒的结局。
参与机构：两个药物滥用治疗的门诊科室为酗酒和吸烟治疗提供平台，3个月内，每周进行治疗，随后3个月巩固治疗。
参与者：96名诊断为酗酒或酒精依赖以及吸烟（每天≥15支）的男性和女性。
干预措施：在开放性研究中所有受试者接受尼古丁贴剂治疗，在双盲条件下随机给予尼古丁口香糖（2 mg）或安慰剂。
结果：对1年的随访数据的分析结果显示，接受尼古丁贴剂+尼古丁口香糖治疗的受试者相比尼古丁+安慰剂者在复吸的间隔时间和12个月后的戒断时间延长方面能获得更好的吸烟结局。对饮酒结局的影响并不显著。
结论：本研究结果与其它未纳入饮酒吸烟人群的大样本试验结果一致。该研究结果显示，联合应用尼古丁贴剂和尼古丁口香糖，较单纯应用尼古丁贴剂治疗戒烟更为有效。
（刘国梁 审校）
Cooney NL, et al. Addiction. 2009 Sep;104(9):1588-96. Epub 2009 Jun 22.
Smoking cessation during alcohol treatment: a randomized trial of combination nicotine patch plus nicotine gum.
Cooney NL, Cooney JL, Perry BL, Carbone M, Cohen EH, Steinberg HR, Pilkey DT, Sevarino K, Oncken CA, Litt MD.
Yale University School of Medicine, New Haven, CT, USA. ned.cooney@yale.edu
AIMS: The primary aim was to compare the efficacy of smoking cessation treatment using a combination of active nicotine patch plus active nicotine gum versus therapy consisting of active nicotine patch plus placebo gum in a sample of alcohol-dependent tobacco smokers in an early phase of out-patient alcohol treatment. A secondary aim was to determine whether or not there were any carry-over effects of combination nicotine replacement on drinking outcomes.
DESIGN: Small-scale randomized double-blind placebo-controlled clinical trial with 1-year smoking and drinking outcome assessment.
SETTING: Two out-patient substance abuse clinics provided a treatment platform of behavioral alcohol and smoking treatment delivered in 3 months of weekly sessions followed by three monthly booster sessions.
PARTICIPANTS: Participants were 96 men and women with a diagnosis of alcohol abuse or dependence and smoking 15 or more cigarettes per day.
INTERVENTION: All participants received open-label transdermal nicotine patches and were randomized to receive either 2 mg nicotine gum or placebo gum under double-blind conditions.
FINDINGS: Analysis of 1-year follow-up data revealed that patients receiving nicotine patch plus active gum had better smoking outcomes than those receiving patch plus placebo gum on measures of time to smoking relapse and prolonged abstinence at 12 months. Alcohol outcomes were not significantly different across medication conditions.
CONCLUSIONS: Results of this study were consistent with results of larger trials of smokers without alcohol problems, showing that combination therapy (nicotine patch plus gum) is more effective than monotherapy (nicotine patch) for smoking cessation.
上一篇：
尼古丁替代治疗、伐尼克兰和安非他酮是否是孕妇戒烟的选择？对子代呼吸系统的影响
下一篇：
安非他酮和认知行为治疗对戒烟治疗期正向情感、负向情感及吸烟冲动的影响
