Simon Joel A, Duncan Carol, Carmody Timothy P, Hudes Esther S
General Internal Medicine Section, Medical Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
Arch Intern Med. 2004 Sep 13;164(16):1797-803. doi: 10.1001/archinte.164.16.1797.
Bupropion hydrochloride is recommended for smoking cessation; however, there have been relatively few clinical trials examining its efficacy.
A total of 244 current smokers were enrolled in an outpatient randomized blinded smoking cessation trial conducted at the San Francisco Veterans Affairs Medical Center, San Francisco, Calif. Of the 244 participants, 121 received a 7-week course of bupropion and 123 received placebo. All participants received 2 months of transdermal nicotine replacement therapy and 3 months of cognitive-behavioral counseling. We determined on-medication treatment, end-of-medication treatment, 3-month, 6-month, and 1-year quit rates.
During treatment with bupropion vs placebo, there was a trend toward increased quit rates among participants randomized to bupropion; the self-reported end-of-medication treatment quit rates were 64% for the bupropion group vs 57% for the placebo group (P =.23). The trend favoring bupropion persisted at 3 months of follow-up (P =.12) but was not apparent at 6 months and 1 year of follow-up (both P>.78). The 12-month quit rates, validated by either saliva cotinine or spousal proxy, were 22% in the bupropion group and 28% in the placebo group (P =.31). Based on biochemical validation, 19% of the bupropion group vs 24% of the placebo group had quit smoking by 1 year (P =.36).
In this randomized blinded trial of mostly veteran participants, the addition of a brief 7-week bupropion trial to treatment with nicotine replacement therapy and counseling did not significantly increase smoking cessation rates.
盐酸安非他酮被推荐用于戒烟；然而，检验其疗效的临床试验相对较少。
共有244名当前吸烟者参加了在加利福尼亚州旧金山退伍军人事务医疗中心进行的一项门诊随机双盲戒烟试验。在这244名参与者中，121人接受了为期7周的安非他酮疗程，123人接受了安慰剂。所有参与者均接受了2个月的经皮尼古丁替代疗法和3个月的认知行为咨询。我们确定了服药期间治疗、停药时治疗、3个月、6个月和1年的戒烟率。
在安非他酮与安慰剂治疗期间，随机分配到安非他酮组的参与者的戒烟率有增加的趋势；安非他酮组自我报告的停药时戒烟率为64%，而安慰剂组为57%（P = 0.23）。在随访3个月时，有利于安非他酮的趋势仍然存在（P = 0.12），但在随访6个月和1年时不明显（两者P>0.78）。经唾液可替宁或配偶代报验证的12个月戒烟率，安非他酮组为22%，安慰剂组为28%（P = 0.31）。基于生化验证，安非他酮组19%的人在1年内戒烟，而安慰剂组为24%（P = 0.36）。
在这项主要针对退伍军人参与者的随机双盲试验中，在尼古丁替代疗法和咨询治疗中增加一个简短的7周安非他酮试验并没有显著提高戒烟率。
