成功戒烟者复吸预测因子：来自于两个伐尼克兰临床III期试验的数据
2010/04/13
背景：寻找复吸的预测因子，有助阐述长期戒断的挑战及为改善戒烟治疗提供方向。
方法：在2项伐尼克兰临床III期试验中，研究对象在治疗4周后出现戒断，且9～12周内仍然持续戒断，对研究对象进行为期1年（52周）的随访，采用post hoc数据分析，研究自治疗结束后（第13周末）复吸的预测因子。
结果：2项试验中，626名吸烟者治疗有效，301（48%）名在随访期复吸（13～52周）。与持续戒断对象相比，直到治疗4周后才出现持续戒断的对象，其复吸优势比增加5倍（OR=4.92, 95% CI: 2.77-8.97; P<.001）。研究前1年内戒断天数超过30天的对象与研究前无戒断的对象相比，更可能出现复吸（OR=2.38, 95% CI: 1.17-5.04; P=.013）。
结论：本研究结果显示，在最初戒断日的戒烟能力及整个治疗期维持戒断是长期戒断的预测因子。治疗后复吸与较长的治疗期的相关性是似乎不合常理，亦未见文献报道。
（刘国梁 审校）
Drug Alcohol Depend. 2010 Jan 11. [Epub ahead of print]
Predictors of post-treatment relapse to smoking in successful quitters: Pooled data from two phase III varenicline trials.
Heffner JL, Lee TC, Arteaga C, Anthenelli RM.
Tri-State Tobacco and Alcohol Research Center, University of Cincinnati Genome Research Institute, 2120 E. Galbraith Rd., Bldg. A, Cincinnati, OH 45237, USA.
BACKGROUND: Identifying predictors of smoking relapse helps to elucidate the challenges of long-term smoking cessation and provides direction for improved treatment development.
METHODS: In this post hoc data analysis, we examined predictors of relapse from end-of-treatment (week 13) through 1-year follow-up (week 52) for treatment-responding participants who achieved the primary efficacy endpoint of 4-week continuous abstinence (weeks 9-12), during two phase III varenicline trials.
RESULTS: Of 626 smokers classified as treatment responders for all treatment groups across both trials, 301 (48%) relapsed during follow-up (weeks 13-52). The odds of relapsing were almost 5 times greater (odds ratio [OR]=4.92, 95% confidence interval [CI]: 2.77-8.97; p<.001) for treatment responders who did not initiate continuous abstinence until the final 4 weeks of the treatment period compared with those who initiated continuous abstinence by their quit date. Participants who reported >30 days of abstinence during the year prior to study entry were significantly more likely to relapse than those who reported 0 days of abstinence (OR=2.38, 95% CI: 1.17-5.04; p=.013).
CONCLUSION: Results of these analyses suggest that the ability to quit smoking on the initial quit date and maintain abstinence throughout the treatment period is a good prognostic indicator for long-term abstinence. The relationship between post-treatment relapse and longer pretreatment periods of abstinence is counterintuitive, yet not without precedence in the literature.
Drug Alcohol Depend. 2010 Jan 11. [Epub ahead of print]
方法：在2项伐尼克兰临床III期试验中，研究对象在治疗4周后出现戒断，且9～12周内仍然持续戒断，对研究对象进行为期1年（52周）的随访，采用post hoc数据分析，研究自治疗结束后（第13周末）复吸的预测因子。
结果：2项试验中，626名吸烟者治疗有效，301（48%）名在随访期复吸（13～52周）。与持续戒断对象相比，直到治疗4周后才出现持续戒断的对象，其复吸优势比增加5倍（OR=4.92, 95% CI: 2.77-8.97; P<.001）。研究前1年内戒断天数超过30天的对象与研究前无戒断的对象相比，更可能出现复吸（OR=2.38, 95% CI: 1.17-5.04; P=.013）。
结论：本研究结果显示，在最初戒断日的戒烟能力及整个治疗期维持戒断是长期戒断的预测因子。治疗后复吸与较长的治疗期的相关性是似乎不合常理，亦未见文献报道。
（刘国梁 审校）
Drug Alcohol Depend. 2010 Jan 11. [Epub ahead of print]
Predictors of post-treatment relapse to smoking in successful quitters: Pooled data from two phase III varenicline trials.
Heffner JL, Lee TC, Arteaga C, Anthenelli RM.
Tri-State Tobacco and Alcohol Research Center, University of Cincinnati Genome Research Institute, 2120 E. Galbraith Rd., Bldg. A, Cincinnati, OH 45237, USA.
BACKGROUND: Identifying predictors of smoking relapse helps to elucidate the challenges of long-term smoking cessation and provides direction for improved treatment development.
METHODS: In this post hoc data analysis, we examined predictors of relapse from end-of-treatment (week 13) through 1-year follow-up (week 52) for treatment-responding participants who achieved the primary efficacy endpoint of 4-week continuous abstinence (weeks 9-12), during two phase III varenicline trials.
RESULTS: Of 626 smokers classified as treatment responders for all treatment groups across both trials, 301 (48%) relapsed during follow-up (weeks 13-52). The odds of relapsing were almost 5 times greater (odds ratio [OR]=4.92, 95% confidence interval [CI]: 2.77-8.97; p<.001) for treatment responders who did not initiate continuous abstinence until the final 4 weeks of the treatment period compared with those who initiated continuous abstinence by their quit date. Participants who reported >30 days of abstinence during the year prior to study entry were significantly more likely to relapse than those who reported 0 days of abstinence (OR=2.38, 95% CI: 1.17-5.04; p=.013).
CONCLUSION: Results of these analyses suggest that the ability to quit smoking on the initial quit date and maintain abstinence throughout the treatment period is a good prognostic indicator for long-term abstinence. The relationship between post-treatment relapse and longer pretreatment periods of abstinence is counterintuitive, yet not without precedence in the literature.
Drug Alcohol Depend. 2010 Jan 11. [Epub ahead of print]
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戒烟与饮酒变化：在四个国家进行的国际烟草控制（ITC）调查
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低尼古丁含量烟草对毒性物质暴露、依赖和戒断的影响
