Underner M, Perriot J, Peiffer G, Harika-Germaneau G, Jaafari N
Consultation de tabacologie, unité de recherche clinique, université de Poitiers, centre hospitalier Henri-Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
Dispensaire Emile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France.
Rev Pneumol Clin. 2018 Sep;74(4):205-214. doi: 10.1016/j.pneumo.2018.04.008.
Three drugs are used as an aid for smoking cessation: nicotine replacement therapy (NRT), varenicline and bupropion. Standard pharmacological strategies have proven their efficacy but may have poor efficacy, especially among "Hard-core smokers" who display low smoking abstinence rates and high relapse rates.
Systematic literature review of data on pharmacological strategies for smoking cessation which are different from standard treatments.
Sixteen studies were included. Higher dose of nicotine patchs increases smoking abstinence rates. Increasing varenicline dose in smokers who do not respond to the standard dose is associated with high success rates. Extended treatment with nicotine patchs is associated with higher abstinence rate at 6 months but not in the long term. Results of studies on extended treatment with oral NRT are conflicting. Extended treatment with varenicline increases smoking cessation rates. Results of studies on extended treatment with bupropion are conflicting as regards smoking cessation rates. Combination therapy of varenicline with nicotine patchs or with bupropion are more effective than varénicline alone. Varenicline using a flexible quit date have similar efficacy compared with previous fixed quit date studies. Pre-cessation treatment with nicotine patchs or with varenicline increases abstinence rates. There is no difference in smoking cessation effectiveness among bupropion, nicotine replacement therapy and their combination. Similarly, there is no differences in abstinence rates between the active bupropion and nicotine gum and the active bupropion and placebo gum groups. Retreatment with varenicline is efficacious in smokers who have previously taken it.
Pharmacological strategies different from standard treatments maybe useful for smoking cessation aid.
有三种药物被用作戒烟辅助药物：尼古丁替代疗法（NRT）、伐尼克兰和安非他酮。标准的药物治疗策略已证实其有效性，但可能效果不佳，尤其是在“铁杆吸烟者”中，他们的戒烟率低且复发率高。
对与标准治疗不同的戒烟药物治疗策略的数据进行系统的文献综述。
纳入了16项研究。更高剂量的尼古丁贴片可提高戒烟率。在对标准剂量无反应的吸烟者中增加伐尼克兰剂量与高成功率相关。延长尼古丁贴片治疗与6个月时较高的戒烟率相关，但从长期来看并非如此。关于口服NRT延长治疗的研究结果相互矛盾。延长伐尼克兰治疗可提高戒烟率。关于安非他酮延长治疗的研究结果在戒烟率方面相互矛盾。伐尼克兰与尼古丁贴片或安非他酮联合治疗比单独使用伐尼克兰更有效。与之前固定戒烟日期的研究相比，使用灵活戒烟日期的伐尼克兰疗效相似。戒烟前使用尼古丁贴片或伐尼克兰治疗可提高戒烟率。安非他酮、尼古丁替代疗法及其联合治疗在戒烟效果上没有差异。同样，活性安非他酮与尼古丁口香糖组和活性安非他酮与安慰剂口香糖组在戒烟率上也没有差异。对之前服用过伐尼克兰的吸烟者进行再治疗是有效的。
与标准治疗不同的药物治疗策略可能有助于戒烟辅助。
