Lancaster Tim, Stead Lindsay F
Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD000191. doi: 10.1002/14651858.CD000191.pub2.
Silver acetate produces an unpleasant taste when combined with cigarettes, thereby producing an aversive stimulus. It has been marketed in various forms with the aim of extinguishing the urge to smoke, by pairing the urge with an unpleasant stimulus.
The aim of this review was to determine the effectiveness of silver acetate products (gum, lozenge, spray) in promoting smoking cessation.
We searched the Cochrane Tobacco Addiction Group specialised trials register. Most recent search was in July 2012.
We included randomised trials of silver acetate for smoking cessation with reports of smoking status at least six months after the beginning of treatment.
We extracted data in duplicate on the type of subjects, the dose and form of silver acetate, the outcome measures, method of randomisation, and completeness of follow-up.The main outcome measure was biochemically validated abstinence from smoking after at least six months follow-up in patients smoking at baseline. Subjects lost to follow-up were counted as continuing smokers. Where appropriate, we performed meta-analysis using a fixed effects model.
Two studies provided long-term follow-up data on patients randomised to silver acetate or placebo. In one of these studies, there was a third arm, randomised to 2mg nicotine gum. The pooled risk ratio for quitting for silver acetate vs placebo was 1.04 (95% confidence interval 0.69 to 1.57).
AUTHORS' CONCLUSIONS: Existing trials show little evidence for a specific effect of silver acetate in promoting smoking cessation. The confidence intervals for the ratio are quite wide. However, the upper limit of the confidence intervals for a positive effect equates to an absolute increase in the smoking cessation rate of about 4%. Any effect of this agent is therefore likely to be smaller than nicotine replacement therapy. The lack of effect of silver acetate may reflect poor compliance with a treatment whose rationale is to create an unpleasant stimulus.
醋酸银与香烟混合时会产生令人不适的味道，从而产生厌恶刺激。它以多种形式销售，目的是通过将吸烟冲动与不愉快刺激配对来消除吸烟冲动。
本综述的目的是确定醋酸银产品（口香糖、含片、喷雾剂）在促进戒烟方面的有效性。
我们检索了Cochrane烟草成瘾小组专门的试验注册库。最近一次检索是在2012年7月。
我们纳入了醋酸银用于戒烟的随机试验，这些试验报告了治疗开始后至少六个月的吸烟状况。
我们对受试者类型、醋酸银的剂量和形式、结局指标、随机化方法以及随访完整性进行了重复数据提取。主要结局指标是对基线时吸烟的患者进行至少六个月随访后经生化验证的戒烟情况。失访的受试者被视为持续吸烟者。在适当情况下，我们使用固定效应模型进行荟萃分析。
两项研究提供了随机分配至醋酸银或安慰剂组患者的长期随访数据。在其中一项研究中，还有第三组被随机分配至2毫克尼古丁口香糖组。醋酸银组与安慰剂组戒烟的合并风险比为1.04（95%置信区间0.69至1.57）。
现有试验几乎没有证据表明醋酸银在促进戒烟方面有特定效果。该比值的置信区间相当宽。然而，积极效果的置信区间上限相当于戒烟率绝对增加约4%。因此，该药物的任何效果可能都小于尼古丁替代疗法。醋酸银缺乏效果可能反映了对一种旨在产生不愉快刺激的治疗方法依从性较差。
