焦虑敏感与吸烟者的痛苦耐受力：与烟草依赖、戒断和戒烟成功的关系†。
Anxiety Sensitivity and Distress Tolerance in Smokers: Relations With Tobacco Dependence, Withdrawal, and Quitting Success†.
机构信息
Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
出版信息
Nicotine Tob Res. 2020 Jan 27;22(1):58-65. doi: 10.1093/ntr/ntz070.
INTRODUCTION
This study examined relations of two affective vulnerabilities, high anxiety sensitivity (AS) and low distress tolerance (DT), with tobacco dependence, withdrawal, smoking cessation, and pharmacotherapy response.
METHODS
Smokers interested in quitting (N = 1067; 52.2% female, 28.1% African American) were randomized to 12 weeks of nicotine patch, nicotine patch plus nicotine lozenge, or varenicline. Baseline questionnaires assessed AS, DT, negative affect, anxiety, and dependence. Withdrawal was assessed the first-week post-quit via ecological momentary assessment.
RESULTS
DT, but not AS, predicted biochemically confirmed point-prevalence abstinence at multiple endpoints: weeks 4, 12, 26, and 52 post-quit (ps < .05); relations remained after controlling for pharmacotherapy treatment, AS, baseline negative affect, anxiety, and anxiety disorder history (ps < .05). Additional exploratory analyses examining week 4 abstinence showed DT predicted abstinence (p = .004) even after controlling for baseline dependence, post-quit withdrawal (craving and negative affect), and treatment. DT moderated treatment effects on abstinence in exploratory analyses (interaction p = .025); those with high DT were especially likely to be abstinent at week 4 with patch plus lozenge versus patch alone.
CONCLUSIONS
DT, but not AS, predicted abstinence over 1 year post-quit (higher DT was associated with higher quit rates), with little overlap with other affective measures. DT also predicted early abstinence independent of dependence and withdrawal symptoms. Results suggest low DT may play a meaningful role in motivation to use tobacco and constitute an additional affective risk factor for tobacco cessation failure beyond negative affect or clinical affective disorders.
IMPLICATIONS
People in a stop-smoking study who reported a greater ability to tolerate distress were more likely to quit smoking and remain smoke-free 1 year later. Smokers with high DT were more likely to be smoke-free 4 weeks after their target quit day if they received nicotine patch plus nicotine lozenge rather than nicotine patch alone.
TRIAL REGISTRATION
NCT01553084.
介绍
本研究探讨了两种情感脆弱性，即高焦虑敏感（AS）和低痛苦容忍（DT），与烟草依赖、戒断、戒烟和药物治疗反应的关系。
方法
有戒烟意愿的吸烟者（N=1067；52.2%为女性，28.1%为非裔美国人）被随机分为尼古丁贴片 12 周、尼古丁贴片加尼古丁含片或伐伦克林。基线问卷评估 AS、DT、负性情绪、焦虑和依赖。戒断后第一周通过生态瞬间评估评估戒断。
结果
DT，但不是 AS，预测了多个终点的生物化学确认的点患病率戒烟：戒烟后 4、12、26 和 52 周（p<0.05）；在控制药物治疗、AS、基线负性情绪、焦虑和焦虑障碍史后，这些关系仍然存在（p<0.05）。对第 4 周戒烟进行的额外探索性分析表明，DT 预测了戒烟（p=0.004），即使在控制基线依赖、戒断后（渴望和负性情绪）和治疗后也是如此。DT 在探索性分析中调节了治疗对戒烟的影响（交互作用 p=0.025）；那些 DT 较高的人，与单独使用贴片相比，用贴片加含片在第 4 周时更有可能戒烟。
结论
DT，但不是 AS，预测了戒烟后 1 年的戒烟率（DT 越高，戒烟率越高），与其他情感测量几乎没有重叠。DT 还预测了独立于依赖和戒断症状的早期戒烟。结果表明，低 DT 可能在使用烟草的动机中发挥重要作用，并构成除负性情绪或临床情感障碍外，烟草戒断失败的另一个情感危险因素。
意义
在一项戒烟研究中，报告自己更能忍受痛苦的人更有可能戒烟，并且在 1 年后仍然不吸烟。如果接受尼古丁贴片加尼古丁含片而不是单独使用尼古丁贴片，那些 DT 较高的人在戒烟目标日的第 4 周更有可能不吸烟。
试验注册
NCT01553084。
Zotero 插件