Gross J, Johnson J, Sigler L, Stitzer M L
Behavioral Pharmacology Research Unit, John Hopkins/Bayview Medical Center, Baltimore, MD 21224.
Addict Behav. 1995 May-Jun;20(3):371-81. doi: 10.1016/0306-4603(94)00078-d.
Nicotine gum has been shown to be effective in improving abstinence rates, and in reducing post-cessation withdrawal distress and weight gain. However, the dose effects of nicotine gum on these outcomes is not known. In the present study, we varied the amount of 2 mg nicotine gum prescribed to motivated quitters to explore the hypotheses (a) that motivated quitters would use more pieces of gum when coached and counseled to do so and (b) that there would be a dose-related effect of gum use on abstinence, withdrawal symptoms, and weight gain. One hundred seventy-seven volunteers were assigned to chew either 0, 7, 15, or 30, pieces per day of 2 mg nicotine gum. Biological verification of gum use and smoking abstinence were assessed in community volunteers who attended an intensive behavioral counseling program for smoking cessation while using nicotine gum for 3 months. In the survival analysis at 12 weeks, gum-group assignment was not related to successful abstinence. In the subset of 42 abstinent subjects, there was a strong positive relationship between pieces per day of nicotine gum used and saliva cotinine. However, there was substantial variability in groups of subjects reporting similar amounts of gum use. Withdrawal symptom reporting was not related to either gum use or cotinine levels. Weight gain was significantly related in a dose-dependent manner to salivary cotinine levels, but not to gum group assignment, with high and low cotinine subjects gaining on average, 4.0 and 6.6 pounds, respectively. Discussion of the use of high levels of nicotine gum is addressed. Consistent with earlier work, the study provided further support for the relationship between nicotine replacement level and post-cessation weight gain.
尼古丁口香糖已被证明在提高戒烟率、减轻戒烟后戒断不适和体重增加方面有效。然而，尼古丁口香糖对这些结果的剂量效应尚不清楚。在本研究中，我们改变了给有戒烟意愿者开具的2毫克尼古丁口香糖的用量，以探究以下假设：（a）在得到指导和咨询后，有戒烟意愿者会使用更多片口香糖；（b）口香糖的使用量与戒烟、戒断症状及体重增加之间存在剂量相关效应。177名志愿者被分配为每天咀嚼0、7、15或30片2毫克的尼古丁口香糖。在参加强化行为戒烟咨询项目并使用尼古丁口香糖3个月的社区志愿者中，对口香糖使用情况和戒烟进行了生物学验证。在12周的生存分析中，口香糖组的分配与成功戒烟无关。在42名成功戒烟的受试者子集中，每天使用的尼古丁口香糖片数与唾液可替宁之间存在强烈的正相关关系。然而，在报告使用相似数量口香糖的受试者组中存在很大差异。戒断症状报告与口香糖使用或可替宁水平均无关。体重增加与唾液可替宁水平呈显著的剂量依赖性相关，但与口香糖组分配无关，高可替宁水平和低可替宁水平的受试者平均分别增重4.0磅和6.6磅。文中讨论了高剂量尼古丁口香糖的使用情况。与早期研究一致，该研究进一步支持了尼古丁替代水平与戒烟后体重增加之间的关系。
