Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1930 Monroe Street, Suite 200, Madison, WI, 53711, USA.
Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Psychopharmacology (Berl). 2018 Jul;235(7):2065-2075. doi: 10.1007/s00213-018-4903-y. Epub 2018 Apr 25.
To examine the effects of five intervention components on smokers' adherence to combined nicotine patch and nicotine gum during a quit attempt and assess whether adherence is related to cessation.
Smokers interested in quitting (N = 513; 59% female; 87% White) received nicotine patch plus nicotine gum and participated in a 2x2x2x2x2 randomized factorial experiment (i.e., 32 treatment conditions) evaluating five intervention components: (1) medication adherence counseling versus none; (2) automated medication adherence calls versus none; (3) electronic medication monitoring with feedback and counseling versus e-monitoring alone; (4) 26 versus 8 weeks of nicotine patch plus nicotine gum; and (5) maintenance counseling versus none. Adherence was assessed over the first 6 weeks post-target quit day via timeline follow-back (nicotine patch) and electronic medication dispenser (gum).
In the first 6 weeks post-quit day, 12% of participants used no patches or gum, and 40% used the patch every day. Only 1.4% used both patch and gum adherently every day in the 6 weeks post-target quit day. E-monitoring counseling increased gum use (from 1.9 to 2.6 pieces/day; p < .001) but did not increase abstinence. More adherent patch and gum use in the first 6 weeks were each associated with higher point-prevalence abstinence rates through 1 year.
This large experiment with electronic monitoring of nicotine gum adherence showed that e-monitoring counseling increased gum use but not abstinence. Adherence to nicotine patch and to gum were each strongly related to abstinence, but it is unclear whether adherence increases abstinence, or relapse causes medication discontinuation.
ClinicalTrials.gov NCT01120704.
考察五种干预成分对吸烟者在戒烟尝试期间联合使用尼古丁贴片和尼古丁口香糖的依从性的影响，并评估依从性是否与戒烟有关。
有戒烟意愿的吸烟者（N=513；59%为女性；87%为白人）接受尼古丁贴片加尼古丁口香糖，并参与了一项 2x2x2x2x2 随机析因实验（即 32 种治疗条件），评估五种干预成分：（1）药物依从性咨询与无咨询；（2）自动药物依从性电话与无电话；（3）电子药物监测与反馈和咨询与电子监测单独；（4）26 周与 8 周尼古丁贴片加尼古丁口香糖；（5）维持咨询与无咨询。在目标戒烟日之后的头 6 周内，通过时间线随访（尼古丁贴片）和电子药物分配器（口香糖）来评估依从性。
在目标戒烟日后的头 6 周内，有 12%的参与者没有使用贴片或口香糖，有 40%的参与者每天使用贴片。只有 1.4%的参与者在目标戒烟日后的 6 周内每天都能正确使用贴片和口香糖。电子监测咨询增加了口香糖的使用（从每天 1.9 片增加到 2.6 片；p<.001），但没有增加戒烟率。在头 6 周内更严格地使用贴片和口香糖与 1 年内更高的点患病率戒烟率相关。
这项关于电子监测尼古丁口香糖依从性的大型实验表明，电子监测咨询增加了口香糖的使用，但没有增加戒烟率。对尼古丁贴片和口香糖的依从性都与戒烟密切相关，但尚不清楚是依从性增加了戒烟率，还是药物中断导致了复发。
ClinicalTrials.gov NCT01120704。
