Abdul-Kader J, Airagnes G, D'almeida S, Limosin F, Le Faou A-L
Department of psychiatry and addictology, hôpitaux universitaires Paris Ouest, AP-HP, 75015 Paris, France.
Department of psychiatry and addictology, hôpitaux universitaires Paris Ouest, AP-HP, 75015 Paris, France; Faculté de médecine, Sorbonne Paris Cité, université Paris Descartes, 75006 Paris, France; Population-based epidemiological cohorts, UMS 011, Inserm, 94800 Villejuif, France; Aging and chronic diseases, VIMA, UMR 1168, Inserm, 94800 Villejuif, France.
Rev Pneumol Clin. 2018 Jun;74(3):160-169. doi: 10.1016/j.pneumo.2018.03.004. Epub 2018 Apr 9.
Smoking cessation treatments have been proved effective to stop smoking. For pharmacological treatments, nicotine replacement therapies (NRT) as well as bupropion allow to increase 6 month-abstinence rates by more than 80% in comparison with placebo while varenicline prescription doubles success rates in the same conditions. These results mean that for 10 smokers who quit with placebo, 18 are expected to quit with NRT or bupropion and 28 are expected to quit with varenicline. Varenicline is 50% more effective than nicotine patch and 70% more effective than nicotine gum. Nevertheless, a combination including NRT patch and oral nicotine forms is as effective as varenicline, thus leading to encourage the prescription of a combination NRT when NRT are chosen. For these three pharmacological treatments, cardiovascular as well as neuropsychiatric tolerance were not found statistically different from placebo in randomized controlled trials. Yet, bupropion prescription leads to an increasing risk of seizure (1/1000 to 1/1500). For behavioral treatment, motivational interviewing as well as cognitive behavior therapies are been proven to be effective to stop smoking but few smokers have access to this treatment. Smoking cessation mobile application and smartphone application seem to be promising in terms of effectiveness and might be useful to reach more smokers.
戒烟治疗已被证明对戒烟有效。在药物治疗方面，与安慰剂相比，尼古丁替代疗法（NRT）以及安非他酮可使6个月戒烟率提高80%以上，而在相同条件下，伐尼克兰处方可使成功率翻倍。这些结果意味着，对于10名使用安慰剂戒烟的吸烟者，预计有18名使用NRT或安非他酮戒烟，28名使用伐尼克兰戒烟。伐尼克兰比尼古丁贴片有效50%，比尼古丁口香糖有效70%。然而，包括NRT贴片和口服尼古丁形式的联合用药与伐尼克兰效果相同，因此在选择NRT时，鼓励开具NRT联合用药的处方。对于这三种药物治疗，在随机对照试验中，心血管以及神经精神耐受性在统计学上与安慰剂无差异。然而，安非他酮处方会导致癫痫发作风险增加（1/1000至1/1500）。对于行为治疗，动机性访谈以及认知行为疗法已被证明对戒烟有效，但很少有吸烟者能获得这种治疗。戒烟移动应用程序和智能手机应用程序在有效性方面似乎很有前景，可能有助于覆盖更多吸烟者。
