Bars Matthew P, Banauch Gisela I, Appel David, Andreachi Michael, Mouren Philippe, Kelly Kerry J, Prezant David J
Chief Medical Officer, Office of Medical Affairs, New York City Fire Department, 9 Metrotech Ctr, Brooklyn, NY 11201, USA.
Chest. 2006 Apr;129(4):979-87. doi: 10.1378/chest.129.4.979.
After the World Trade Center (WTC) collapse, 15% (1,767) of rescue workers from the Fire Department of the City of New York (FDNY) considered themselves to be current cigarette smokers. Post-WTC collapse, 98% reported acute respiratory symptoms, and 81% reported health concerns. Nonetheless, 29% of current smokers increased tobacco use, and 23% of ex-smokers resumed cigarette smoking.
To determine the effect of a comprehensive tobacco-cessation program using combination tobacco-dependency treatment medications adjusted to the individual's daily tobacco use.
FDNY cigarette smokers enrolled in "Tobacco Free With FDNY," a no-cost quit-smoking program providing counseling, support, and medications. At the end of the 3-month treatment phase and at the 6-month and 12-month follow-up visits, abstinence rates were confirmed by expired carbon monoxide levels or by the verification of a household member.
FDNY Bureau of Health Services between August 1, 2002 and October 30, 2002.
A total of 220 current cigarette smokers from the FDNY.
At study enrollment, the mean (+/- SD) tobacco use was 20 +/- 7 cigarettes per day, and the mean tobacco dependency, as assessed by a modified Fagerstrom test score, was 6.7 +/- 2.5 (maximum score, 10). Based on tobacco use, 20% of enrollees used three types of nicotine medications, 64% used two types, 14% used one type, and 3% used no medications. Additionally, 14% of enrollees used bupropion sustained release. The confirmed continuous abstinence rates were 47%, 36%, and 37%, respectively, after 3 months of treatment and at the 6-month and 12-month follow-up. Abstinence rates did not correlate with the history of tobacco use but correlated inversely with tobacco dependency. Adverse events and maximal nicotine medication use were unrelated, and no one experienced a serious adverse event.
Tobacco dependency treatment using combination nicotine medications is effective and safe. Future studies should consider the following: (1) both history of tobacco use and withdrawal symptoms to determine the number and dose of nicotine medications; and (2) continuing combination treatment for > 3 months.
世界贸易中心（WTC）倒塌后，纽约市消防局（FDNY）15%（1767人）的救援人员认为自己是当前吸烟者。世贸中心倒塌后，98%的人报告有急性呼吸道症状，81%的人报告有健康问题。尽管如此，29%的当前吸烟者增加了烟草使用量，23%的曾经吸烟者重新开始吸烟。
确定一项综合戒烟计划的效果，该计划使用根据个人每日烟草使用量调整的联合烟草依赖治疗药物。
FDNY吸烟者参加了“与FDNY一起无烟”项目，这是一个免费的戒烟项目，提供咨询、支持和药物。在3个月治疗阶段结束时以及6个月和12个月的随访中，通过呼出一氧化碳水平或家庭成员核实来确认戒烟率。
2002年8月1日至2002年10月30日期间的FDNY卫生服务局。
来自FDNY的220名当前吸烟者。
在研究入组时，平均（±标准差）烟草使用量为每天20±7支香烟，通过改良的法格斯特龙测试评分评估的平均烟草依赖程度为6.7±2.5（最高分10分）。根据烟草使用情况，20%的入组者使用三种尼古丁药物，64%的人使用两种，14%的人使用一种，3%的人未使用药物。此外，14%的入组者使用安非他酮缓释片。在治疗3个月后以及6个月和12个月随访时，确认的持续戒烟率分别为47%、36%和37%。戒烟率与烟草使用史无关，但与烟草依赖呈负相关。不良事件与最大尼古丁药物使用量无关，且没有人经历严重不良事件。
使用联合尼古丁药物进行烟草依赖治疗是有效且安全的。未来的研究应考虑以下几点：（1）根据烟草使用史和戒断症状来确定尼古丁药物的数量和剂量；（2）持续联合治疗超过3个月。
