Etter Jean-François, Laszlo Evelyne
Institute of Social and Preventive Medicine, University of Geneva, Geneva, Switzerland.
J Clin Psychopharmacol. 2007 Apr;27(2):151-5. doi: 10.1097/JCP.0b013e318033bd72.
We tested whether a reduction of cigarette consumption obtained after 6 months of nicotine replacement therapy was maintained 5 years after the end of this treatment. Heavy smokers (mean = 30 cigarettes per day) who had no intention of quitting smoking were randomly assigned to a 6-month treatment of nicotine (15-mg patch, 4-mg gum, and/or 10-mg inhaler, n = 265), placebo (n = 269), or no intervention (n = 389). Products were sent by mail, and education was limited to a booklet. Of 923 participants, 879 (95%) were followed after 6 months and 671 (73%) after 5 years. After 6 months, smoking reduction was larger for nicotine (-10.9 cigarettes per day) than for placebo (-8.7) and no treatment (-4.9, all P <or= 0.022). After 5 years, cigarette consumption (20 cigarettes per day, all P >or= 0.2) and smoking cessation rates (17% to 21%, all P > 0.2) were similar in all groups. In smokers, 5-year continuous abstinence was higher in those who had reduced their cigarette consumption by at least 50% between baseline and 6 months than in those who did not reduce (11.9% vs 5.6%; P = 0.011; odds ratio, 2.3; 95% confidence interval, 1.2-4.2). Thus, the initial effect of the treatment on smoking reduction was not maintained after 5 years. However, reducing cigarette consumption was associated with a higher chance of subsequently quitting smoking. Nicotine replacement therapy in unmotivated smokers had no deleterious effect on dependence levels and smoking behavior.
我们测试了尼古丁替代疗法6个月后吸烟量的减少在该治疗结束5年后是否仍能维持。无意戒烟的重度吸烟者（平均每天吸30支烟）被随机分为三组，分别接受为期6个月的尼古丁治疗（15毫克贴片、4毫克口香糖和/或10毫克吸入器，n = 265）、安慰剂治疗（n = 269）或不进行干预（n = 389）。产品通过邮寄方式发送，教育仅限于一本小册子。923名参与者中，879名（95%）在6个月后接受随访，671名（73%）在5年后接受随访。6个月后，尼古丁组的吸烟量减少幅度（每天-10.9支）大于安慰剂组（-8.7支）和未治疗组（-4.9支，P均≤0.022）。5年后，所有组的吸烟量（每天20支，P均≥0.2）和戒烟率（17%至21%，P均>0.2）相似。在吸烟者中，基线至6个月期间吸烟量减少至少50%的人5年持续戒烟率高于未减少吸烟量的人（11.9%对5.6%；P = 0.011；优势比，2.3；95%置信区间，1.2 - 4.2）。因此，治疗对减少吸烟的初始效果在5年后未得到维持。然而，减少吸烟量与随后戒烟的较高几率相关。对无戒烟意愿的吸烟者进行尼古丁替代疗法对依赖水平和吸烟行为没有有害影响。
