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安非他酮缓释片与实际戒烟咨询:结局的预测因素

Bupropion SR and counseling for smoking cessation in actual practice: predictors of outcome.

作者信息

Swan Gary E, Jack Lisa M, Curry Sue, Chorost Michael, Javitz Harold, McAfee Tim, Dacey Sara

机构信息

Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA.

出版信息

Nicotine Tob Res. 2003 Dec;5(6):911-21. doi: 10.1080/14622200310001646903.

Abstract

To date, only one study has been published on individual characteristics associated with outcome following standard treatment with bupropion SR for smoking cessation. To investigate treatment outcome beyond the 6-week end-of-treatment point, the present study examined characteristics associated with more clinically relevant smoking endpoints following treatment with bupropion SR in a large health care system. A total of 1,524 smokers (649 men and 875 women) of average age 45.1 years were randomized to receive one of four combinations of bupropion SR (150 or 300 mg) and behavioral counseling (tailored mailings or proactive telephone counseling) and assessed for point-prevalent smoking status at 3 and 12 months. Multiple logistic regression analyses of potential risk factors for 12-month point-prevalent smoking and for persistent smoking (point-prevalent smoking at both follow-ups) following treatment were conducted for men and women combined and separately. Risk factors for smoking at both endpoints in the combined sample included treatment with tailored mailings, female gender, younger age, higher levels of tobacco dependence, shorter previous quit attempts, previous use of nicotine replacement therapy, and report of current depressive symptoms or lifetime depression. Risk factors for smoking following treatment identified in women only included treatment with the lower dose of bupropion SR, younger age, and higher perceived stress, whereas those that were unique to men included the presence of lifetime depression. The results are discussed in terms of their implications for the need for more effective treatments in general, and the role of individual differences in the likelihood of returning to smoking following treatment for quitting.

摘要

迄今为止,仅发表了一项关于安非他酮缓释片标准戒烟治疗后与治疗结果相关个体特征的研究。为了研究治疗结束6周后的治疗结果,本研究在一个大型医疗系统中,考察了安非他酮缓释片治疗后与更具临床相关性的吸烟终点相关的特征。共有1524名平均年龄45.1岁的吸烟者(649名男性和875名女性)被随机分配接受安非他酮缓释片(150毫克或300毫克)与行为咨询(定制邮件或主动电话咨询)的四种组合之一,并在3个月和12个月时评估时点吸烟状况。对治疗后12个月时点吸烟和持续吸烟(两次随访时均为时点吸烟)的潜在风险因素进行了多因素logistic回归分析,包括男性和女性合并分析以及单独分析。合并样本中两个终点吸烟的风险因素包括接受定制邮件治疗、女性、年龄较小、烟草依赖程度较高、既往戒烟尝试时间较短、既往使用尼古丁替代疗法以及报告当前抑郁症状或终生抑郁。仅在女性中确定的治疗后吸烟风险因素包括接受较低剂量的安非他酮缓释片治疗、年龄较小和感知压力较高,而男性特有的风险因素包括存在终生抑郁。将根据这些结果对一般更有效治疗的需求以及个体差异在戒烟治疗后复吸可能性中的作用的影响进行讨论。

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