Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine Cincinnati, OH 45219, USA.
Nicotine Tob Res. 2013 Feb;15(2):393-400. doi: 10.1093/ntr/nts135. Epub 2012 Sep 4.
Few studies have evaluated predictors of smoking cessation outcomes in smokers with attention-deficit/hyperactivity disorder (ADHD), which could help to improve suboptimal treatment outcomes in this population. The purpose of this study was to examine pretreatment thoughts about smoking abstinence (i.e., desire to quit, perceived difficulty quitting, and expected success in quitting) as predictors of smoking cessation outcomes in smokers with ADHD and to determine the extent to which treatment adherence mediates these relationships.
Participants were adult smokers with ADHD (n = 255), who were enrolled in a multisite smoking cessation study and received either osmotic-release oral system methylphenidate (OROS-MPH) or placebo in combination with transdermal nicotine replacement and brief cessation counseling. Bootstrapped logistic regression models were generated to test main effects of thoughts about abstinence on smoking cessation outcomes and to examine treatment adherence as a mediator of these relationships.
Desire to quit and expected success in quitting, but not perceived difficulty quitting, predicted smoking cessation outcomes, as did all of the treatment adherence variables (i.e., percent sessions attended, counselor ratings of counseling adherence, and percent patch adherence). Counseling adherence partially mediated the relationship between smoking cessation outcomes and both pretreatment desire to quit and expected success.
Smokers with ADHD who have higher self-efficacy (i.e., expected success) and motivation (i.e., desire) to quit are more adherent to smoking cessation counseling and have better smoking cessation outcomes. Additional research is needed to determine whether treatment-seeking smokers with ADHD would benefit from an intervention designed to increase self-efficacy and motivation to quit.
很少有研究评估注意力缺陷/多动障碍（ADHD）吸烟者戒烟结果的预测因素，这可能有助于改善该人群中治疗效果不理想的情况。本研究的目的是检验治疗前关于戒烟的想法（即戒烟的愿望、戒烟的难度感知和戒烟的预期成功率）是否可以预测 ADHD 吸烟者的戒烟结果，并确定治疗依从性在多大程度上可以调节这些关系。
参与者为患有 ADHD 的成年吸烟者（n=255），他们参加了一项多地点戒烟研究，接受了渗透型口服系统哌甲酯（OROS-MPH）或安慰剂联合透皮尼古丁替代和简短的戒烟咨询。使用 bootstrap 逻辑回归模型检验关于戒烟的想法对戒烟结果的主要影响，并检验治疗依从性对这些关系的中介作用。
戒烟的愿望和预期成功，而不是戒烟的难度感知，预测了戒烟结果，所有治疗依从性变量（即参加的治疗次数百分比、咨询师对咨询依从性的评分和贴片依从性百分比）也是如此。咨询依从性部分中介了戒烟结果与治疗前戒烟的愿望和预期成功率之间的关系。
有更高戒烟自我效能（即预期成功率）和动机（即愿望）的 ADHD 吸烟者对戒烟咨询的依从性更高，戒烟结果更好。需要进一步研究以确定是否寻求治疗的 ADHD 吸烟者会从旨在提高戒烟自我效能和动机的干预措施中受益。
