哮喘联盟

   摘要
   目的：患有创伤后应激障碍的退伍军人群体吸烟的比例比普通人群高2－3倍，而成功戒烟的概率却不足普通人群的一半。针对患有创伤后应激障碍（PTSD）和烟瘾的退伍军人的接受与承诺疗法（ACT-PT）主要致力于帮助退伍军人克服戒烟过程中的情感挑战，本项目旨在评估该疗法的可行性、可接受性和初步效果。
   方法：19例每天吸烟数量大于等于15支并患有PTSD的退伍军人参加了本次ACT-PT的开放性试验。每名受试者参加9次每周个人咨询和8周尼古丁贴片治疗。主要的试验结果显示该戒烟疗法具有可行性和可接受性。次要的结局指标包括呼出的一氧化碳浓度（提示7天吸烟节制的情况）、对吸烟的渴望以及PTSD相关症状等。
   结果：ACT-PT疗法的依从性较好（74%），并且患者满意度较高。在项目进行期间，受试者进行了多次戒烟尝试（M = 3.6，SD = 4.2），并且在为期三个月的随访期间表现出更强的能成功戒烟的信心。在治疗结束后，37%的受试者成功戒烟并且16%的受试者在三个月的随访期间也仍然保持戒烟状态。总的来说，受试者在治疗结束以及三个月随访时分别减少了62%和43%的吸烟量，并且受试者的PTSD相关症状及吸烟欲望对比基线显著下降。
   结论：ACT-PT疗法是帮助患有PTSD的退伍军人成功戒烟的有效方法，未来还应在随机对照试验中评估其有效性。
 

（刘国梁 审校）
J Dual Diagn. 2014 Dec 9:0. [Epub ahead of print]


 

Acceptance and Commitment Therapy Smoking Cessation Treatment for Veterans with Posttraumatic Stress Disorder: A Pilot Study.
 

Kelly MM1, Sido H, Forsyth JP, Ziedonis DM, Kalman D, Cooney JL.
 

Abstract
OBJECTIVE: Veterans with PTSD smoke at rates 2-3 times higher than the general population, while their quit rate is less than half that of the general population. The present study evaluated the feasibility, acceptability, and preliminary efficacy of Acceptance and Commitment Therapy for Veterans with posttraumatic stress disorder (PTSD) and Tobacco Addiction (ACT-PT), which focuses on helping Veterans overcome emotional challenges to quitting smoking.
METHODS: Veterans with current PTSD who smoked 15 or more cigarettes/day (N = 19) participated in an open trial of ACT-PT. Participants attended nine weekly individual counseling sessions and received eight weeks of nicotine patch. Primary outcomes included feasibility and acceptability of the intervention, and secondary outcomes included expired-air carbon monoxide confirmed seven-day point prevalence abstinence, cravings, and PTSD symptoms.
RESULTS: The retention rate for ACT-PT was good (74%) and client satisfaction ratings were high. Participants made multiple quit attempts (M = 3.6, SD = 4.2) during the study period and were significantly more confident that they could quit smoking at three-month follow-up. At the end of treatment, 37% of participants were abstinent from smoking and 16% were abstinent at three-month follow-up. Overall, participants reduced their smoking by 62% at the end of treatment and 43% at three-month follow-up. PTSD symptoms and smoking urges significantly decreased from baseline to the end of treatment and three-month follow-up.
CONCLUSIONS: ACT-PT appears to be a promising smoking cessation treatment for Veterans with PTSD. Future research should evaluate ACT-PT in a randomized controlled trial.
 

J Dual Diagn. 2014 Dec 9:0. [Epub ahead of print]