Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia.
Addiction. 2020 Nov;115(11):2123-2129. doi: 10.1111/add.15083. Epub 2020 May 14.
Non-daily smokers (NDS) comprise a large fraction of US smokers. Despite little or no dependence, as typically assessed, intermittent smokers (ITS) have difficulty quitting smoking. A randomized clinical trial comparing the effect of nicotine gum with placebo on quitting smoking in non-daily smokers did not find an effect on overall abstinence. We undertook an analysis to assess whether using nicotine gum versus placebo when tempted to smoke could reduce incidence of lapses in those situations.
Within a 6-week randomized, placebo-controlled clinical trial of nicotine gum, analyses contrasted the outcome of temptation episodes where gum was or was not used.
Smoking cessation research clinic in Pittsburgh, PA, USA.
A total of 255 adult ITS (131 nicotine gum, 124 placebo) seeking help for smoking cessation.
Nicotine gum (2 mg) versus placebo for up to 8 weeks, with as-needed dosing instructions.
Outcome was lapsing in temptation episodes, as reported by participants via ecological momentary assessment (EMA). Propensity scores predicting gum use from situational factors (e.g. mood, social setting, smoking cues) served as a control variable.
Participants reported 2713 temptation episodes, 46.0% (1248) of which resulted in smoking (lapsing). There was a significant gum use × active treatment interaction (P = 0.0009). Using nicotine gum decreased the odds of lapsing by 55% compared with using placebo [odds ratio (OR) = 0.45; 0.22-0.94]; when gum was not used, the assigned gum condition made no significant difference (OR = 1.53; 0.78-3.01; Bayes factor = 0.14). The nicotine effect was not reliably different when participants were trying to achieve abstinence versus when trying to maintain abstinence (OR = 0.44; 0.10, 2.03; P = 0.294; Bayes factor = 0.11), for men and women (OR = 1.68; 0.58, 4.87; P = 0.343; Bayes factor = 0.10), or for participants with some or no dependence (OR = 0.88; 0.30, 2.59; P = 0.811; Bayes factor = 0.06).
When used in response to temptation to smoke, 2 mg nicotine gum can help to prevent lapses among non-daily smokers.
非每日吸烟者（NDS）在美国吸烟者中占很大比例。尽管间歇性吸烟者（ITS）依赖程度较低或不存在，但他们戒烟却很困难。一项比较尼古丁口香糖与安慰剂对非每日吸烟者戒烟效果的随机临床试验并未发现总体戒烟率的影响。我们进行了一项分析，以评估在有吸烟冲动时使用尼古丁口香糖与安慰剂相比，是否可以减少这种情况下的复吸发生率。
在一项为期 6 周的尼古丁口香糖随机、安慰剂对照临床试验中，我们对比了在有或没有使用口香糖的情况下，有吸烟冲动时的试验结果。
美国宾夕法尼亚州匹兹堡的戒烟研究诊所。
共有 255 名成年 ITS（131 名尼古丁口香糖，124 名安慰剂），他们正在寻求戒烟帮助。
使用 2 毫克尼古丁口香糖或安慰剂，最多使用 8 周，并根据需要给予用药指导。
参与者通过生态瞬时评估（EMA）报告吸烟冲动时的复吸情况。从情境因素（如情绪、社交环境、吸烟线索）预测口香糖使用的倾向评分作为控制变量。
参与者报告了 2713 次吸烟冲动，其中 46.0%（1248 次）导致吸烟（复吸）。口香糖使用与积极治疗之间存在显著的交互作用（P=0.0009）。与使用安慰剂相比，使用尼古丁口香糖可使复吸的几率降低 55%[比值比（OR）=0.45；0.22-0.94]；而当不使用口香糖时，使用分配的口香糖并没有显著差异（OR=1.53；0.78-3.01；贝叶斯因子=0.14）。当参与者试图戒烟时，与试图保持戒烟状态时相比，尼古丁的效果没有明显差异（OR=0.44；0.10, 2.03；P=0.294；贝叶斯因子=0.11），无论是男性还是女性（OR=1.68；0.58, 4.87；P=0.343；贝叶斯因子=0.10），还是有或没有依赖的参与者（OR=0.88；0.30, 2.59；P=0.811；贝叶斯因子=0.06）。
在有吸烟冲动时使用 2 毫克尼古丁口香糖，可以帮助非每日吸烟者预防复吸。
