Kotlyar Michael, Lindgren Bruce R, Vuchetich John P, Le Chap, Mills Anne M, Amiot Elizabeth, Hatsukami Dorothy K
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States; Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States.
Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806 420 Delaware Street SE, Minneapolis, MN 55455, United States.
Addict Behav. 2017 Aug;71:18-24. doi: 10.1016/j.addbeh.2017.02.018. Epub 2017 Feb 10.
Smokers are often advised to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal symptoms.
Eighty-four smokers completed two laboratory sessions in random order. At one session, nicotine lozenge was given immediately after a stressor (to approximate current recommended use - i.e., after craving and withdrawal symptoms occur); at the other session subjects were randomized to receive nicotine lozenge at time points ranging from immediately to 30min prior to the stressor. Withdrawal symptoms and urge to smoke were measured using the Minnesota Nicotine Withdrawal Scale and the Questionnaire of Smoking Urges (QSU).
Relative to receiving lozenge after the stressor, a smaller increase in pre-stressor to post-stressor withdrawal symptom scores occurred when lozenge was used immediately (p=0.03) and 10min prior (p=0.044) to the stressor. Results were similar for factors 1 and 2 of the QSU when lozenge was used immediately prior to the stressor (p<0.03) and for factor 1 of the QSU when lozenge was used 10min prior to the stressor (p=0.028). Absolute levels of post-stressor withdrawal symptom and urge to smoke severity were lower when lozenge was given prior to versus after a stressor.
Administering the nicotine lozenge prior to a smoking trigger can decrease trigger induced craving and withdrawal symptoms. Future studies are needed to determine if such use would increase cessation rates. Clinicaltrials.gov # NCT01522963.
吸烟者在出现渴望或戒断症状时，常被建议使用尼古丁含片。但这对于预防复吸可能为时已晚。本研究评估了在常见吸烟诱因出现之前使用尼古丁含片是否能将诱因诱发的渴望和戒断症状的增加降至最低。
84名吸烟者以随机顺序完成了两次实验室测试。在一次测试中，在应激源出现后立即给予尼古丁含片（以近似当前推荐的使用方式，即在渴望和戒断症状出现后）；在另一次测试中，受试者被随机分配在应激源出现前从立即到30分钟的不同时间点接受尼古丁含片。使用明尼苏达尼古丁戒断量表和吸烟渴望问卷（QSU）来测量戒断症状和吸烟冲动。
与在应激源出现后接受含片相比，在应激源出现时立即（p = 0.03）和提前10分钟（p = 0.044）使用含片时，应激源前到应激源后戒断症状评分的增加较小。当在应激源出现前立即使用含片时，QSU的因素1和2的结果相似（p < 0.03），当在应激源出现前10分钟使用含片时，QSU的因素1的结果相似（p = 0.028）。在应激源之前而非之后给予含片时，应激源后戒断症状的绝对水平和吸烟冲动的严重程度较低。
在吸烟诱因出现之前给予尼古丁含片可以减少诱因诱发的渴望和戒断症状。需要进一步的研究来确定这种使用方式是否会提高戒烟率。Clinicaltrials.gov # NCT01522963。
