Frank S H, Jaén C R
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Prim Care. 1993 Mar;20(1):251-68.
Nicotine addiction is the most prevalent of all substance dependence, resulting in profound medical, social, and psychologic costs. Evidence supporting the addictive nature of nicotine is compelling. Recognition of this addiction has opened treatment options not currently available, including pharmacologic options. Physicians can contribute to cessation success even with minimal interventions. For those interested in stronger interventions, careful assessment of the smoker is essential. This assessment should identify the degree of nicotine dependence, the presence of negative affect related to cessation, and the pervasiveness of meaning of tobacco in the patient's life. Treatment options include white knuckle or will power quitting, guided self-treatment, referral, and office cessation with or without pharmacologic support. A four-visit protocol that includes (1) recruitment, (2) assessment, (3) treatment, and (4) relapse prevention is described.
尼古丁成瘾是所有物质依赖中最为普遍的，会带来巨大的医学、社会和心理代价。支持尼古丁成瘾性的证据确凿。认识到这种成瘾性开启了目前尚无的治疗选择，包括药物治疗选项。即使进行极少的干预，医生也能有助于戒烟成功。对于那些有兴趣进行更强干预措施的人来说，仔细评估吸烟者至关重要。这种评估应确定尼古丁依赖程度、与戒烟相关的负面情绪的存在，以及烟草在患者生活中的意义的普遍性。治疗选择包括硬撑或凭借意志力戒烟、引导式自我治疗、转诊，以及有无药物支持的门诊戒烟。本文描述了一个包含（1）招募、（2）评估、（3）治疗和（4）预防复发的四次就诊方案。
