Benowitz N L, Zevin S, Jacob P
Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, and the Departments of Medicine and Psychiatry, University of California, San Francisco,
J Pharmacol Exp Ther. 1998 Dec;287(3):958-62.
Nicotine replacement therapy is believed to facilitate smoking cessation both by relieving withdrawal symptoms and by reducing the psychological reward from smoking. The latter might occur via down-regulation of nicotine receptors in the brain, which might require high levels of nicotine exposure. Our study examined the hypothesis that transdermal nicotine, dosed up to three times the doses currently recommended for smoking cessation, would suppress nicotine intake from ad libitum smoking in a dose-dependent manner. Eleven volunteers with no desire to quit smoking received placebo or 21, 42, and 63 mg/day transdermal nicotine, with and without cigarette smoking, in a blinded crossover study. Cigarette smoking was permitted as desired. Transdermal nicotine suppressed nicotine intake from cigarette smoking by 3%, 10% and 40% on average in the 21, 42 and 63 mg/day conditions. The number of cigarettes smoked per day declined from an average of 17.2 to 12.7 and the intake of nicotine per cigarette declined from 2.5 to 1.6 mg, comparing placebo and 63 mg nicotine conditions. Our study results suggest that high-dose transdermal nicotine has the potential to substantially suppress the intake of tobacco smoke and could be a useful strategy for smoking cessation therapy or for reducing the harm caused by smoking.
人们认为，尼古丁替代疗法有助于戒烟，其方式一是缓解戒断症状，二是减少吸烟带来的心理奖赏。后者可能是通过下调大脑中的尼古丁受体来实现的，而这可能需要高水平的尼古丁暴露。我们的研究检验了这样一个假设：经皮给予尼古丁，剂量高达目前推荐用于戒烟剂量的三倍，将以剂量依赖的方式抑制随意吸烟时的尼古丁摄入量。在一项双盲交叉研究中，11名无戒烟意愿的志愿者接受了安慰剂或每天21毫克、42毫克和63毫克的经皮尼古丁，无论是否吸烟。允许根据需要吸烟。在每天21毫克、42毫克和63毫克的情况下，经皮尼古丁平均分别抑制了3%、10%和40%的吸烟尼古丁摄入量。比较安慰剂和63毫克尼古丁的情况，每天吸烟数量从平均17.2支降至12.7支，每支香烟的尼古丁摄入量从2.5毫克降至1.6毫克。我们的研究结果表明，高剂量经皮尼古丁有潜力大幅抑制烟草烟雾的摄入量，可能是戒烟治疗或减少吸烟危害的一种有用策略。
