Vermont Center on Behavior and Health, University of Vermont, Burlington, VT 05401, USA; Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA.
Vermont Center on Behavior and Health, University of Vermont, Burlington, VT 05401, USA; Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA; Department of Psychological Science, University of Vermont, Burlington, VT 05401, USA.
Prev Med. 2017 Nov;104:100-116. doi: 10.1016/j.ypmed.2017.06.016. Epub 2017 Jun 21.
The present systematic review examines whether very low nicotine content (VLNC) cigarettes ameliorate withdrawal-induced impairments in behavioral/cognitive performance. PubMed, PsycInfo, and Web of Science were searched for performance effects of VLNC cigarettes. For inclusion, reports had to be in English, published in a peer-reviewed journal through June 2017, examine VLNC cigarettes (<0.2mg nicotine yield), include ≥2hour smoking abstinence or reduced nicotine exposure, and examine performance. 19 of 1243 articles reviewed met inclusion criteria. Poorer performance after smoking VLNC versus normal nicotine content (NNC) cigarettes was observed across 7 of 10 domains, including reaction time (8/11), short-term memory (3/10), sustained attention (4/6), inhibitory control (1/4), long-term memory (3/3 studies), and response variability (2/2). In two studies, combining VLNC smoking with nicotine replacement therapy (NRT) resulted in performance that was comparable to performance after NNC smoking. VLNC versus NNC differences were not discerned in motor control/functioning (0/2), visuospatial processing (0/2), learning (0/1), or verbal fluency (0/1). Eleven of nineteen (58%) studies were rated of Good or Excellent quality. Overall, VLNC cigarettes may not fully ameliorate withdrawal-induced disruptions in performance, although this varies by domain, with the strongest evidence for reaction time. Importantly, combining VLNC cigarettes with NRT appears to ameliorate withdrawal that is not reduced by VLNC cigarettes alone. As only 19 studies were identified, many domains are under-investigated. A more thorough evaluation of the extent to which VLNC cigarettes affect withdrawal-impaired performance may be warranted.
本系统评价研究考察了极低尼古丁含量（VLNC）香烟是否能改善戒断引起的行为/认知表现损伤。通过 PubMed、PsycInfo 和 Web of Science 检索了 VLNC 香烟对表现影响的相关研究。纳入标准为：英语发表、同行评审期刊、研究 VLNC 香烟（尼古丁生成量<0.2mg）、至少 2 小时吸烟戒断或减少尼古丁暴露、以及检测表现。1243 篇文章中，有 19 篇符合纳入标准。与正常尼古丁含量（NNC）香烟相比，VLNC 香烟在 10 个领域中的 7 个领域（包括反应时间[8/11]、短期记忆[3/10]、持续注意力[4/6]、抑制控制[1/4]、长期记忆[3/3 项研究]和反应变异性[2/2]）的表现更差。在两项研究中，将 VLNC 吸烟与尼古丁替代疗法（NRT）联合使用，结果与 NNC 吸烟后的表现相当。在运动控制/功能[0/2]、视空间处理[0/2]、学习[0/1]或言语流畅性[0/1]方面，VLNC 与 NNC 没有差异。19 项研究中有 11 项（58%）被评为高质量或极好质量。总体而言，VLNC 香烟可能无法完全改善戒断引起的表现损伤，尽管在不同领域存在差异，反应时间的证据最强。重要的是，将 VLNC 香烟与 NRT 联合使用似乎可以改善 VLNC 香烟单独戒烟无法改善的戒断症状。由于仅确定了 19 项研究，许多领域的研究仍不充分。可能需要更全面地评估 VLNC 香烟在多大程度上影响戒断损伤后的表现。
