Gonzales David, Jorenby Douglas E, Brandon Thomas H, Arteaga Carmen, Lee Theodore C
OHSU Smoking Cessation Center, Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
Addiction. 2010 Nov;105(11):2002-13. doi: 10.1111/j.1360-0443.2010.03058.x. Epub 2010 Sep 1.
We assessed to what degree smokers who fail to quit on the target quit date (TQD) or lapse following TQD eventually achieve success with continued treatment.
A secondary analysis of pooled data of successful quitters treated with varenicline (306 of 696), bupropion (199 of 671) and placebo (121 of 685) from two identically-designed clinical trials of varenicline versus bupropion sustained-release and placebo.
Multiple research centers in the US.
Adult smokers (n==2052) randomized to 12 weeks drug treatment plus 40 weeks follow-up.
The primary end-point for the trials was continuous abstinence for weeks 9-12. TQD was day 8. Two patterns of successful quitting were identified. Immediate quitters (IQs) were continuously abstinent for weeks 2-12. Delayed quitters (DQs) smoked during 1 or more weeks for weeks 2-8.
Cumulative continuous abstinence (IQs + DQs) increased for all treatments during weeks 3-8. Overall IQs and DQs for varenicline were (24%; 20%) versus bupropion (18.0%, P=0.007; 11.6%, P<0.001) or placebo (10.2%, P<0.001; 7.5%, P<0.001). However, DQs as a proportion of successful quitters was similar for all treatments (varenicline 45%; bupropion 39%; placebo 42%) and accounted for approximately one-third of those remaining continuously abstinent for weeks 9-52. No gender differences were observed by quit pattern. Post-treatment relapse was similar across groups.
Our data support continuing cessation treatments without interruption for smokers motivated to remain in the quitting process despite lack of success early in the treatment.
我们评估了那些在目标戒烟日期（TQD）未能成功戒烟或在TQD之后复吸的吸烟者最终通过持续治疗取得成功的程度。
对来自两项设计相同的关于伐尼克兰与缓释安非他酮及安慰剂对比的临床试验中接受伐尼克兰治疗成功戒烟者（696例中的306例）、安非他酮治疗成功戒烟者（671例中的199例）和安慰剂治疗成功戒烟者（685例中的121例）的汇总数据进行二次分析。
美国多个研究中心。
成年吸烟者（n = 2052），随机分为接受12周药物治疗加40周随访。
试验的主要终点是第9至12周持续戒烟。TQD为第8天。确定了两种成功戒烟模式。即时戒烟者（IQs）在第2至12周持续戒烟。延迟戒烟者（DQs）在第2至8周的1周或更多周内吸烟。
在第3至8周期间，所有治疗组的累积持续戒烟率（IQs + DQs）均有所上升。伐尼克兰组的总体IQs和DQs分别为（24%；20%），而安非他酮组为（18.0%，P = 0.007；11.6%，P < 0.001），安慰剂组为（10.2%，P < 0.001；7.5%，P < 0.001）。然而，所有治疗组中DQs占成功戒烟者的比例相似（伐尼克兰组45%；安非他酮组39%；安慰剂组42%），且占第9至52周持续戒烟者的约三分之一。未观察到戒烟模式的性别差异。各治疗组治疗后复发情况相似。
我们的数据支持对于那些尽管在治疗早期未成功但仍有动力留在戒烟过程中的吸烟者继续不间断地进行戒烟治疗。
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