Peechatka Alyssa L, Molokotos Elena K, Zegel Maya, Lukas Scott E, Janes Amy C
Functional Integration of Addiction Research Laboratory (FIARL), McLean Imaging Center, McLean Hospital, Belmont, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Psychiatry. 2019 Aug 8;10:559. doi: 10.3389/fpsyt.2019.00559. eCollection 2019.
Despite the availability of smoking cessation strategies, smoking cue-induced craving remains a relatively untreated relapse risk factor. Utilizing nicotine-free electronic cigarettes (e-cigarettes) to extinguish the motivational influence of smoking cues may be a viable approach to address cue reactivity. In this pilot study, 26 daily tobacco smokers used nicotine-free e-cigarettes while being maintained on daily transdermal sustained-release nicotine replacement therapy (NRT) to mitigate pharmacological withdrawal. Sensitivity to cue-induced craving, measured by the rise in craving after a visual cue exposure task, was assessed at a baseline visit after smoking as usual and again after 2 weeks of nicotine-free e-cigarette and NRT use. Participants' pattern and amount of tobacco cigarette smoking were evaluated on both visits and 1 month posttreatment. Cue-induced craving significantly decreased after the 2-week intervention, yet withdrawal scores increased during this time. One month after study completion, participants continued to report significantly lower overall cigarette craving and conventional tobacco cigarette use. Including the 34.8% that were totally abstinent, 65.2% reported smoking fewer than 10 cigarettes per week (compared to 87.2 per week at baseline for the entire group). A linear regression revealed that greater baseline cue-induced craving predicted better outcomes, whereas more withdrawal at the e-cigarette visit was related to more smoking at 1 month. This proof-of-concept pilot study suggests that the addition of nicotine-free e-cigarettes to an existing strategy of transdermal NRT may attenuate cue-induced craving for tobacco smoking. A larger sample that is powered for detecting additional factors and longer-term outcomes is warranted.
尽管有戒烟策略，但吸烟线索诱发的渴望仍然是一个相对未得到治疗的复发风险因素。利用不含尼古丁的电子烟来消除吸烟线索的动机影响可能是解决线索反应性的一种可行方法。在这项试点研究中，26名每日吸烟者在维持每日经皮缓释尼古丁替代疗法（NRT）以减轻药物戒断反应的同时使用不含尼古丁的电子烟。通过视觉线索暴露任务后渴望程度的上升来衡量的线索诱发渴望的敏感性，在像往常一样吸烟后的基线访视时以及在使用不含尼古丁的电子烟和NRT 2周后再次进行评估。在两次访视时以及治疗后1个月评估参与者吸烟的模式和数量。2周干预后，线索诱发的渴望显著降低，但在此期间戒断分数增加。研究完成1个月后，参与者继续报告总体香烟渴望和传统香烟使用显著减少。包括34.8%完全戒烟的人在内，65.2%的人报告每周吸烟少于10支（相比之下，整个组在基线时每周吸烟87.2支）。线性回归显示，更高的基线线索诱发渴望预示着更好的结果，而在电子烟访视时更多的戒断与1个月时更多的吸烟有关。这项概念验证试点研究表明，在现有的经皮NRT策略中添加不含尼古丁的电子烟可能会减轻线索诱发的吸烟渴望。有必要进行一个更大的样本研究，以检测其他因素和长期结果。
