Shiffman Saul, Scharf Deborah M, Shadel William G, Gwaltney Chad J, Dang Qianyu, Paton Stephanie M, Clark Duncan B
Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
J Consult Clin Psychol. 2006 Apr;74(2):276-85. doi: 10.1037/0022-006X.74.2.276.
Tests of addiction treatments seldom reveal where treatment exercises its effect (i.e., promoting initial abstinence, preventing lapses, and/or impeding progression from lapse to relapse). The authors illustrate analyses distinguishing effects on these milestones in a randomized trial of high-dose nicotine patch (35 mg; n = 188) versus placebo (n = 136) in adult smokers, who used electronic diaries to monitor smoking in real time during 5 weeks of treatment. High-dose patch promoted initial abstinence (hazard ratio [HR] = 1.3) and decreased the risk of lapsing among those who achieved abstinence (HR = 1.6). The biggest effect of treatment was to prevent progression to relapse among those who had lapsed (HR = 7.1). Analysis of effects by milestones may enhance understanding of cessation treatments and their mechanisms of action.
成瘾治疗测试很少能揭示治疗效果体现在何处（即促进初次戒烟、预防复吸，和/或阻止从复吸发展为再次成瘾）。作者在一项针对成年吸烟者的随机试验中阐述了区分对这些关键节点影响的分析，该试验对比了高剂量尼古丁贴片（35毫克；n = 188）与安慰剂（n = 136）的效果，吸烟者在5周治疗期间使用电子日记实时监测吸烟情况。高剂量贴片促进了初次戒烟（风险比[HR] = 1.3），并降低了已戒烟者复吸的风险（HR = 1.6）。治疗的最大效果是防止已复吸者再次成瘾（HR = 7.1）。按关键节点分析效果可能会增进对戒烟治疗及其作用机制的理解。
