Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Drugs. 2010 Apr 16;70(6):643-50. doi: 10.2165/11536100-000000000-00000.
Globally, tobacco kills almost 5 million people around the world annually. Seven first-line pharmacotherapies are currently available and recommended by the United States Public Health Service (USPHS) clinical practice guideline for treating tobacco dependence, all of which have been proven to be effective for increasing tobacco abstinence rates when used as monotherapy. However, not all smokers are able to quit with single-drug therapy. Some smokers may benefit from combination therapy that includes the simultaneous use of different nicotine replacement therapies (NRTs) or medications with different mechanisms of action (e.g. NRT and bupropion). Combination therapy with different types of NRT may provide a therapeutic advantage by increasing serum nicotine concentrations, and combination therapy with different drugs may capitalize on synergy obtained from two different mechanisms of action. However, controversy exists regarding this approach. Available data suggests that combination therapy may increase abstinence rates compared with monotherapy. However, the cost effectiveness of this approach has not been clearly demonstrated.
全球范围内，烟草每年导致近 500 万人死亡。目前有七种一线药物疗法被美国公共卫生署（USPHS）的临床实践指南推荐用于治疗烟草依赖，所有这些药物在作为单一疗法使用时都已被证明可以有效提高戒烟率。然而，并非所有吸烟者都能通过单一药物治疗戒烟。一些吸烟者可能受益于联合治疗，包括同时使用不同的尼古丁替代疗法（NRT）或具有不同作用机制的药物（例如 NRT 和安非他酮）。不同类型 NRT 的联合治疗可能通过增加血清尼古丁浓度提供治疗优势，而不同药物的联合治疗可能利用两种不同作用机制获得的协同作用。然而，这种方法存在争议。现有数据表明，与单一疗法相比，联合疗法可能会提高戒烟率。然而，这种方法的成本效益尚未得到明确证明。
