Effect of high-dose nicotine patch on craving and negative affect leading up to lapse episodes
Effect of high-dose nicotine patch on craving and negative affect leading up to lapse episodes
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DOI：
10.1007/s00213-013-3429-6
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发表时间：
2014-07-01
影响因子：
3.4
通讯作者：
Shiffman, Saul
中科院分区：
文献类型：
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作者：
Ferguson, Stuart G.;Shiffman, Saul
尼古丁贴片已被可靠地证明可以改善戒烟结果，但大多数使用者在治疗期间仍然会戒烟，然后复发。虽然尼古丁贴片已被证明可以减轻背景烟瘾，但它对提示诱发的烟瘾（与戒烟事件的发生有关）的影响却知之甚少。在这里，我们研究了尼古丁贴片对烟瘾强度的影响以及在烟瘾发作前几小时所经历的负面情绪。参与者是 185 名在大剂量（35 毫克）尼古丁贴片随机、双盲试验中戒烟的吸烟者，在治疗的前 5 周内至少失效一次。参与者在尝试戒烟期间使用电子日记来监测他们的吸烟情况、情绪和渴望。数据表明，戒烟日的进展（外部事件或内部状态的变化）导致渴望和负面情绪上升，并在戒烟过程中累积。众所周知，尼古丁可以降低背景渴望和负面影响，但贴片和安慰剂之间的差异似乎在戒断发作前的几个小时内消失了。了解这些症状在衰退之前“激增”的过程并开发治疗方法来应对它是值得研究的努力。
Nicotine patches have been reliably demonstrated to improve smoking cessation outcomes but most users still lapse, and then relapse, during treatment. While patch has been shown to alleviate background cravings, its effects on cue-induced cravings - which have been linked to the occurrence of lapse events - are poorly understood.Here we investigate the effect of nicotine patch on the intensity of craving and negative affect experienced during the hours immediately preceding lapse episodes.Participants were 185 smokers who had quit in the context of a randomized, double-blind trial of high-dose (35 mg) nicotine patch and who lapsed at least once during the first 5 weeks of treatment. Participants used electronic diaries to monitor their smoking, affect, and craving during their cessation attempt.The data suggest that developments on the lapse day - either external events or changes in internal states - caused craving and negative affect to rise, cumulating in the lapse. Nicotine is known to lower background craving and negative affect, but the difference between patch and placebo appeared to dissipate in the hours immediately preceding lapse episodes. Understanding the process by which these symptoms "spike" prior to a lapse - and developing treatments to counter it - are worthy research endeavors.