Piper Megan E, Vasilenko Sara A, Cook Jessica W, Lanza Stephanie T
Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Department of Medicine, University of Wisconsin, Madison, WI, USA.
Addiction. 2017 Feb;112(2):330-339. doi: 10.1111/add.13613. Epub 2016 Oct 28.
To (1) identify distinct classes of smokers based on quit day withdrawal symptoms and (2) explore the relations between withdrawal classes and demographics, tobacco dependence, treatment and smoking outcomes.
Secondary data analysis of participants (n = 1504) in a randomized double-blind placebo-controlled multi-site smoking cessation trial who provided ecological momentary assessments of withdrawal symptoms on their quit day. Participants received smoking cessation counseling and were randomized to receive placebo or one of five active pharmacotherapies.
Research offices in Madison and Milwaukee, Wisconsin, USA.
Adult smokers (n = 1236; 58% female, 86% white), recruited from the community via advertisements, who abstained on their quit day.
Demographics and tobacco dependence were assessed at baseline and participants carried palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger and anhedonia) on their quit day. Point-prevalence abstinence and latency to relapse were assessed at 8 weeks and 6 months post-quit.
Latent class analysis identified four withdrawal classes [Akaike information criterion (AIC) = 70.09]: Moderate withdrawal (64% of sample), high craving-anhedonia (8% of sample), affective withdrawal (13% of sample) and hunger (15% of sample). The high craving-anhedonia class reported significantly higher dependence (P < 0.01), were less likely to have received combination nicotine replacement, reported lower week 8 abstinence rates and relapsed sooner than those in the moderate withdrawal class (P < 0.05). The affective withdrawal class reported higher levels of baseline negative affect and life-time psychopathology (P < 0.05) and relapsed more quickly than the moderate withdrawal class (P < 0.01).
While the majority of smokers report typical levels of withdrawal symptoms on their quit day, more than one-third report extreme craving or extreme negative affective or extreme hunger responses to initial abstinence. These distinct quit-day withdrawal symptom patterns are related to baseline characteristics, treatment and cessation success.
(1) 根据戒烟日的戒断症状确定不同类型的吸烟者，(2) 探讨戒断类型与人口统计学、烟草依赖、治疗及吸烟结果之间的关系。
对一项随机双盲安慰剂对照多中心戒烟试验的参与者（n = 1504）进行二次数据分析，这些参与者在戒烟日提供了戒断症状的生态瞬时评估。参与者接受戒烟咨询，并被随机分配接受安慰剂或五种活性药物疗法之一。
美国威斯康星州麦迪逊和密尔沃基的研究办公室。
通过广告从社区招募的成年吸烟者（n = 1236；58% 为女性，86% 为白人），他们在戒烟日成功戒烟。
在基线时评估人口统计学和烟草依赖情况，参与者携带掌上电脑记录戒烟日的戒断症状（渴望、消极情绪、注意力不集中、饥饿和快感缺失）。在戒烟后8周和6个月评估点患病率戒断情况和复发潜伏期。
潜在类别分析确定了四种戒断类型 [赤池信息准则(AIC)=70.09]：中度戒断（占样本的64%）、高渴望 - 快感缺失（占样本的8%）、情感性戒断（占样本的13%）和饥饿（占样本的15%）。高渴望 - 快感缺失类型报告的依赖性显著更高（P < 0.01），接受联合尼古丁替代治疗的可能性更小，第8周的戒烟率更低，且比中度戒断类型复发更早（P < 0.05）。情感性戒断类型报告的基线消极情绪和终生精神病理学水平更高（P < 0.05），且比中度戒断类型复发更快（P < 0.01）。
虽然大多数吸烟者在戒烟日报告典型的戒断症状水平，但超过三分之一的吸烟者报告对初始戒烟有极度渴望、极度消极情绪或极度饥饿反应。这些不同的戒烟日戒断症状模式与基线特征、治疗及戒烟成功相关。
