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高剂量尼古丁贴片对复发发作特征的影响。

Effect of high-dose nicotine patch on the characteristics of lapse episodes.

机构信息

School of Pharmacy and Menzies Research Institute,University of Tasmania, Hobart, Tasmania 7001, Australia.

出版信息

Health Psychol. 2010 Jul;29(4):358-66. doi: 10.1037/a0019367.

Abstract

OBJECTIVE

Nicotine patch improves treatment outcomes, but lapses are still common. To understand the process of relapse on patch, we investigated differences in the antecedents (withdrawal, setting, triggers) of lapse episodes experienced on high-dose (35 mg) nicotine patches versus placebo.

DESIGN

Participants were smokers who lapsed during a randomized, double-blind trial of active patches (n = 100) versus placebo (n = 85). Participants used electronic diaries to monitor their smoking, affect, and activities in real time for 5 weeks during their cessation attempt.

RESULTS

We analyzed 490 lapse episodes (active: 266; placebo: 224). Lapses on nicotine patch were characterized by significantly lower positive affect and higher negative affect than placebo lapses. Participants treated with high-dose patch were also significantly more likely to lapse in situations involving little or no craving. Situational antecedents of lapses on patch resembled those on placebo.

CONCLUSION

The results suggest that treatment with patch may set a higher threshold for affective stimuli to provoke lapses, but does not change the proximal cues that trigger lapses. This suggests that behavioral relapse-prevention strategies developed for unmedicated smokers should also apply to those treated with nicotine patch.

摘要

目的

尼古丁贴片可改善治疗效果,但仍常出现复吸。为了解贴片复吸的过程,我们研究了使用高剂量(35 毫克)尼古丁贴片和安慰剂时,戒断期间经历的复吸发作的前驱因素(戒断症状、环境、诱因)的差异。

设计

参与者为在一项随机、双盲的活性贴片(n = 100)与安慰剂(n = 85)治疗试验中发生复吸的吸烟者。参与者在戒烟尝试期间使用电子日记实时监测他们的吸烟、情绪和活动 5 周。

结果

我们分析了 490 次复吸发作(活性贴片:266 次;安慰剂:224 次)。与安慰剂相比,尼古丁贴片复吸时的积极情绪显著降低,消极情绪显著升高。使用高剂量贴片治疗的参与者也更有可能在几乎没有或没有烟瘾的情况下发生复吸。贴片复吸的情境前驱因素与安慰剂相似。

结论

结果表明,贴片治疗可能会提高情绪刺激引发复吸的门槛,但不会改变引发复吸的近端线索。这表明针对未用药吸烟者制定的行为复发预防策略也应适用于使用尼古丁贴片治疗的吸烟者。

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