Cohen Gal, Bellanca Carlo Maria, Bernardini Renato, Rose Jed E, Polosa Riccardo
Rose Research Center, Raleigh, NC 27617, USA.
Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy.
iScience. 2024 Oct 22;27(11):111090. doi: 10.1016/j.isci.2024.111090. eCollection 2024 Nov 15.
Cigarette smoking addiction is a leading cause of morbidity and mortality and presents a challenging interventional target. Interventions for stopping smoking offer trade-offs in ability to displace or blunt the effects of cigarettes, which include positive and negative reinforcement, psychological reward, aversiveness, and sensory enjoyment, and which are mediated through nicotine and non-nicotine elements of smoking. Established therapies, which include nicotine replacement therapies (NRTs), varenicline, and bupropion are being supplemented with a growing evidence base for cytisine and nicotine substitution products, with more rapid acting NRTs on the horizon, all of which are expanding individual choice. An understanding of determinants of efficacy can inform a personalized and adaptive approach to smoking cessation, which presents an opportunity to further improve outcomes. This includes tailoring cessation treatment plans based on initial individual response, preference, and tolerability to first line interventions and considering second-line options (including evidence-based combination therapies) when needed.
吸烟成瘾是发病和死亡的主要原因，也是一个具有挑战性的干预目标。戒烟干预措施在替代或减弱香烟影响的能力方面存在权衡，香烟影响包括正性和负性强化、心理奖赏、厌恶感和感官享受，且这些影响是通过吸烟中的尼古丁和非尼古丁成分介导的。已有的疗法，包括尼古丁替代疗法（NRTs）、伐尼克兰和安非他酮，正随着关于金雀花碱和尼古丁替代产品的证据基础不断扩大而得到补充，同时有起效更快的NRTs即将出现，所有这些都在扩大个人选择范围。了解疗效的决定因素可为戒烟提供个性化和适应性方法，这为进一步改善治疗结果提供了契机。这包括根据个体对一线干预措施的初始反应、偏好和耐受性来制定戒烟治疗计划，并在需要时考虑二线选择（包括循证联合疗法）。
