Cardiopulmonary Department, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
J Comp Eff Res. 2013 May;2(3):335-43. doi: 10.2217/cer.13.25.
Tobacco smoke contains many chemicals that are harmful and cause carcinogenesis. The aim of this study was to confirm the relationship between smoking and changes in respiratory functional and laboratory parameters comparing, in particular, smoking-cessation treatment's outcomes between smokers who reduce tobacco consumption (reducers) and smokers who quit completely (quitters).
MATERIALS & METHODS: A total of 181 current smokers were prospectively enrolled. All of the participants completed a sociodemographic questionnaire and underwent 3 months of varenicline plus nicotine-replacement therapy combined with basic counseling. Laboratory tests and clinical and lung-function parameters were evaluated at entry and after 3 months of therapy. After 3 months of smoking-cessation treatment, subjects were sorted into two subgroups: quitters and reducers.
After 3 months of combined therapy, 56% of the subjects (101 patients) stopped smoking; the remaining patients reduced. Significant improvements in pulmonary-function tests (especially in the 25-75% forced expiratory volume testing) were recorded. The most significant improvements were obtained in quitters: carboxyhemoglobin was reduced by 1.06%, the average expiratory flow between 25 and 75% of vital capacity increased by 16% from predicted, mean serum CEA level decreased by 1.83 ng/ml, heart rate decreased by approximately 16 beats/min on average and forced 1 s expiratory flow increased by 2.57% from predicted. The Fagerström scores showed a positive correlation with the corresponding blood carboxyhemoglobin levels.
Just 3 months of smoking-cessation treatment achieved significant improvements in lung-function parameters and a decrease in serum CEA, mostly in subjects who totally quit smoking. This result confirms the effectiveness of our smoking-cessation treatment and suggests the utility of the selected parameters as tools to motivate and monitor patients.
烟草烟雾中含有许多有害化学物质,可导致致癌作用。本研究旨在通过比较减少烟草消费的吸烟者(减少者)和完全戒烟的吸烟者(戒烟者)之间戒烟治疗结果,确认吸烟与呼吸功能和实验室参数变化之间的关系。
共前瞻性纳入 181 名当前吸烟者。所有参与者均完成了一份社会人口统计学问卷,并接受了 3 个月的伐尼克兰联合尼古丁替代疗法加基础咨询。在入组时和治疗 3 个月后评估实验室检查和临床及肺功能参数。在戒烟治疗 3 个月后,将受试者分为两组:戒烟者和减少者。
联合治疗 3 个月后,56%的受试者(101 例)停止吸烟;其余患者减少吸烟。肺功能测试(尤其是 25%75%用力呼气量测试)显著改善。戒烟者的改善最明显:碳氧血红蛋白降低 1.06%,用力肺活量 25%75%平均呼气流量增加 16%(预测值),平均血清 CEA 水平降低 1.83ng/ml,平均心率降低约 16 次/分钟,用力 1 秒呼气量增加 2.57%(预测值)。Fagerström 评分与相应的血碳氧血红蛋白水平呈正相关。
仅 3 个月的戒烟治疗即可显著改善肺功能参数,并降低血清 CEA,主要在完全戒烟的受试者中。该结果证实了我们戒烟治疗的有效性,并提示所选参数作为激励和监测患者的工具的实用性。