Westman E C, Behm F M, Simel D L, Rose J E
Nicotine Research Laboratory, Durham Veterans Affairs Medical Center, NC, USA.
Arch Intern Med. 1997 Feb 10;157(3):335-40.
The nicotine patch has been widely used for smoking cessation, but not all smokers quit using the patch. Knowing which smokers are likely to succeed with the nicotine patch may improve the efficiency of nicotine patch use.
To identify predictors of smoking abstinence using baseline characteristics, smoking behavior, and withdrawal symptoms.
Using 2 randomized clinical trials of pharmacologic treatment, brief counseling, and quit date formats in the outpatient research clinic setting, predictors of smoking cessation were derived in 1 sample (n = 159), then prospectively validated in an independent sample (n = 48). Subjects smoked 1 pack of cigarettes per day or more and were motivated to quit smoking. Self-report of abstinence at 6 months verified by exhaled carbon monoxide of 8 ppm or less was used.
Abstinence at 6 months was 24% in the derivation set and 25% in the validation set. Using logistic regression, a model containing quit date abstinence (odds ratio, 10.6; 95% confidence interval [CI], 2.9-38.7) and baseline nicotine dependence (odds ratio, 0.75; 95% CI, 0.6-1.0 per unit increase in Fagerstrom score) provided the optimal predictive ability and was validated in the independent set. Quit date abstinence improved the likelihood of 6-month abstinence by 4.1 over baseline (95% CI, 2.6-6.4) for low-nicotine-dependent smokers and 1.2 (95% CI, 0.6-2.2) for high-nicotine-dependent smokers. Quit date smoking altered the likelihood of 6-month abstinence by 0.2 (95% CI, 0.0-0.8) for low-dependent smokers and 0.1 for high-dependent smokers (95% CI, 0.0-0.6).
Abstinence on the quit date and low-nicotine dependence improve the likelihood of smoking abstinence at 6 months. Smoking on the quit date may be an indication for postponing the cessation attempt or adjusting the therapy for smoking cessation.
尼古丁贴片已广泛用于戒烟，但并非所有吸烟者都能通过使用该贴片成功戒烟。了解哪些吸烟者使用尼古丁贴片可能成功，或许能提高尼古丁贴片的使用效率。
利用基线特征、吸烟行为和戒断症状来确定戒烟的预测因素。
在门诊研究诊所环境中，通过两项药物治疗、简短咨询和戒烟日期格式的随机临床试验，在一个样本（n = 159）中得出戒烟的预测因素，然后在一个独立样本（n = 48）中进行前瞻性验证。受试者每天吸烟1包或更多，且有戒烟意愿。采用呼出一氧化碳含量为8 ppm或更低来验证6个月时自我报告的戒烟情况。
在推导组中，6个月时的戒烟率为24%，在验证组中为25%。使用逻辑回归分析，一个包含戒烟日戒烟情况（比值比，10.6；95%置信区间[CI]，2.9 - 38.7）和基线尼古丁依赖程度（比值比，0.75；95%CI，每增加一个单位的法格斯特罗姆评分，为0.6 - 1.0）的模型具有最佳预测能力，并在独立样本中得到验证。对于低尼古丁依赖的吸烟者，与基线相比，戒烟日戒烟使6个月戒烟的可能性提高了4.1（95%CI，2.6 - 6.4）；对于高尼古丁依赖的吸烟者，提高了1.2（95%CI，0.6 - 2.2）。对于低依赖吸烟者，戒烟日吸烟使6个月戒烟的可能性改变了0.2（95%CI，0.0 - 0.8）；对于高依赖吸烟者，改变了0.1（95%CI，0.0 - 0.6）。
戒烟日戒烟和低尼古丁依赖可提高6个月时戒烟的可能性。在戒烟日吸烟可能表明需要推迟戒烟尝试或调整戒烟治疗方案。
