与传统治疗相比，戒烟治疗前使用尼古丁贴片能显著增加戒断率
2009/11/17
前言：先前的研究已经报道了与开始戒烟时使用尼古丁贴片的传统方法相比，戒烟治疗前应用尼古丁贴片能有效提高戒断率。我们假设维持尼古丁水平持续存在能减少吸烟，从而导致对尼古丁吸入依赖的下降，因此有助于戒烟。
方法：本研究对象分为4组，每组100人，在戒断之日前接受为期2周的尼古丁贴片治疗（21 mg/24 hr）或安慰剂贴片治疗，在此期间，受试者吸常规品牌的香烟或低焦油和低尼古丁香烟：采用2（尼古丁贴片）×2（香烟类型）因素设计。从戒断之日起，所有组受试者接受标准的尼古丁贴片治疗，包括为期6周21 mg/24 hr、2周14 mg/24 hr和2周7 mg/24 hr尼古丁贴片治疗。戒断定义为自戒烟开始之日起，受试者自我报告的无吸烟，并通过检测呼气一氧化碳来证实。
结果：戒断治疗前给予尼古丁贴片治疗能将戒断率提高1倍。基于尼古丁依赖性评分的Fagerström测试显示，在对烟草依赖水平较低者中治疗效果较为明显。所有受试者对治疗的耐受性均良好。
讨论：鉴于本研究和前期研究的结果，应该重新对尼古丁替代治疗方法的使用时机进行研究，因为目前该治疗方法主要用于开始戒断之后。
（刘国梁 审校）
Nicotine Tob Res. 2009 Sep;11(9):1067-1075.
Precessation treatment with nicotine patch significantly increases abstinence rates relative to conventional treatment.
Rose JE, Herskovic JE, Behm FM, Westman EC.
INTRODUCTION: Previous studies have reported that smoking abstinence rates are increased when nicotine skin patch treatment is initiated prior to the target quit smoking date, as compared with conventional treatment beginning on the quit date. We hypothesized that smoking in the presence of continuous levels of nicotine would attenuate the reinforcing effects of cigarette smoking and lead to a decline in dependence on inhaled nicotine, thus facilitating cessation.
METHODS: This study involved four groups of smokers (n = 100 per group) who received either nicotine patch (21 mg/24 hr) or placebo patch treatment for 2 weeks before the quit smoking date, and during this period, smoked their usual brands of cigarettes or switched to low-tar and nicotine cigarettes: a 2 (nicotine patch) x 2 (cigarette type) factorial design. From the quit date on, all groups received standard nicotine patch treatment, consisting of 6 weeks of 21 mg/24 hr, 2 weeks of 14 mg/24 hr, and 2 weeks of 7 mg/24 hr. Abstinence was defined as self-report of no smoking from the quit date on, confirmed by expired-air carbon monoxide.
RESULTS: Continuous abstinence rates were approximately doubled by precessation nicotine patch treatment. The treatment mainly benefited smokers with lower levels of dependence, based on Fagerström Test for Nicotine Dependence score. All treatments were well tolerated.
DISCUSSION: In view of these findings and similar results from previous studies, current labeling of the nicotine patch, which recommends using nicotine replacement therapy only after the quit date, should be reexamined.
Rose JE, et al. Nicotine Tob Res. 2009 Sep;11(9):1067-75.
方法：本研究对象分为4组，每组100人，在戒断之日前接受为期2周的尼古丁贴片治疗（21 mg/24 hr）或安慰剂贴片治疗，在此期间，受试者吸常规品牌的香烟或低焦油和低尼古丁香烟：采用2（尼古丁贴片）×2（香烟类型）因素设计。从戒断之日起，所有组受试者接受标准的尼古丁贴片治疗，包括为期6周21 mg/24 hr、2周14 mg/24 hr和2周7 mg/24 hr尼古丁贴片治疗。戒断定义为自戒烟开始之日起，受试者自我报告的无吸烟，并通过检测呼气一氧化碳来证实。
结果：戒断治疗前给予尼古丁贴片治疗能将戒断率提高1倍。基于尼古丁依赖性评分的Fagerström测试显示，在对烟草依赖水平较低者中治疗效果较为明显。所有受试者对治疗的耐受性均良好。
讨论：鉴于本研究和前期研究的结果，应该重新对尼古丁替代治疗方法的使用时机进行研究，因为目前该治疗方法主要用于开始戒断之后。
（刘国梁 审校）
Nicotine Tob Res. 2009 Sep;11(9):1067-1075.
Precessation treatment with nicotine patch significantly increases abstinence rates relative to conventional treatment.
Rose JE, Herskovic JE, Behm FM, Westman EC.
INTRODUCTION: Previous studies have reported that smoking abstinence rates are increased when nicotine skin patch treatment is initiated prior to the target quit smoking date, as compared with conventional treatment beginning on the quit date. We hypothesized that smoking in the presence of continuous levels of nicotine would attenuate the reinforcing effects of cigarette smoking and lead to a decline in dependence on inhaled nicotine, thus facilitating cessation.
METHODS: This study involved four groups of smokers (n = 100 per group) who received either nicotine patch (21 mg/24 hr) or placebo patch treatment for 2 weeks before the quit smoking date, and during this period, smoked their usual brands of cigarettes or switched to low-tar and nicotine cigarettes: a 2 (nicotine patch) x 2 (cigarette type) factorial design. From the quit date on, all groups received standard nicotine patch treatment, consisting of 6 weeks of 21 mg/24 hr, 2 weeks of 14 mg/24 hr, and 2 weeks of 7 mg/24 hr. Abstinence was defined as self-report of no smoking from the quit date on, confirmed by expired-air carbon monoxide.
RESULTS: Continuous abstinence rates were approximately doubled by precessation nicotine patch treatment. The treatment mainly benefited smokers with lower levels of dependence, based on Fagerström Test for Nicotine Dependence score. All treatments were well tolerated.
DISCUSSION: In view of these findings and similar results from previous studies, current labeling of the nicotine patch, which recommends using nicotine replacement therapy only after the quit date, should be reexamined.
Rose JE, et al. Nicotine Tob Res. 2009 Sep;11(9):1067-75.
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药物治疗以获得短期戒烟的有效性：系统综述和荟萃分析
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