A comparison of smoking cessation treatments for persons with schizophrenia and other serious mental illnesses
A comparison of smoking cessation treatments for persons with schizophrenia and other serious mental illnesses
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DOI：
10.1080/02791072.2007.10399888
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发表时间：
2007-12-01
影响因子：
2.8
通讯作者：
Layne, Wendy
中科院分区：
文献类型：
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作者：
Gallagher, Sandra M.;Penn, Patricia E.;Layne, Wendy
在美国，患有任何DSM-IV诊断的精神疾病的成年人吸烟量几乎占吸烟量的一半（Lasser et al. 2000）。这项研究比较了两种针对精神分裂症或其他严重精神疾病患者的戒烟干预措施，因为国家数据表明：（1）他们的吸烟率是普通人群的两到三倍;（2）对这一人群的戒烟干预措施研究不足;（3）大多数戒烟研究排除了严重精神疾病患者;（4）大多数戒烟研究排除了严重精神疾病患者。以及（4）停止导致公共卫生保健储蓄和客户可支配收入储蓄。这项研究包括大量患有严重精神疾病的人（N = 181），他们被随机分配到三组之一：应急强化（CR），CR+尼古丁贴片（21 mg，CR+NRT）16周，以及最小干预，自我戒烟对照组。这些参与者被跟踪了36周。CR是通过逐步增加的经济补偿来实现和维持禁欲的，这是通过过期的一氧化碳（CO）来验证的。戒烟率，测定过期的CO，更高，与唾液可替宁戒烟率不一致。在第20周和第36周，可替宁的戒烟率较低，干预组和对照组之间的差异较小。然而，有证据表明吸烟减少，重要的是，没有证据表明精神恶化。
Adults with any DSM-IV diagnosed mental illness smoke nearly half of the cigarettes consumed in the U.S. (Lasser et al. 2000). This study compared two smoking cessation interventions for persons with schizophrenia or other serious mental illness because national data suggests that: (1) they smoke at two to three times the rate of the general population; (2) cessation interventions for this population are understudied; (3) most cessation studies exclude persons with serious mental illness; and (4) cessation results in public health care savings and disposable income savings for clients. This study included a large number of persons with serious mental illness (N = 181) who were randomly assigned to one of three groups: contingent reinforcement (CR), CR plus nicotine patch (21 mg, CR+NRT) for 16 weeks, and a minimal intervention, self-quit control group. These participants were followed for 36 weeks. CR was accomplished with escalating financial compensation for achieving and maintaining abstinence as verified by expired carbon monoxide (CO). Quit rates, as measured by expired CO, were higher and discordant with saliva cotinine quit rates. Cotinine showed lower quit rates and small differences between intervention and control participants at weeks 20 and 36. There was, however, evidence of reduced smoking and importantly, no evidence of psychiatric exacerbation.