Nicotine replacement therapy in patients with cardiovascular disease: guidelines for health professionals
Nicotine replacement therapy in patients with cardiovascular disease: guidelines for health professionals
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DOI：
10.1046/j.1360-0443.2001.961115472.x
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发表时间：
2001-11-01
期刊：
影响因子：
6
通讯作者：
Hajek, P
中科院分区：
文献类型：
--
作者：
McRobbie, H;Hajek, P
吸烟与心血管疾病（CVD）之间的因果关系是众所周知的，鼓励患有CVD的吸烟者戒烟非常重要。尼古丁替代疗法（NRT）是戒烟的有效辅助手段。然而，由于产品标签上的警告，其在CVD患者中的使用通常被避免。这是不合理的，因为NRT用于依赖性吸烟者比吸烟安全得多。以下指南可用于向CVD患者推荐NRT时的论证：（i）NRT通常可推荐给CVD吸烟者，他们在没有此类帮助的情况下尝试戒烟但失败;（ii）在过去4周内发生严重心血管事件的患者中，请患者的咨询医生参与。在不太严重的情况下，这是不需要的;（iii）确保剂量不超过制造商的建议;（iv）警告患者停止使用NRT，如果他们复吸;和（v）目标动机吸烟者（即寻求帮助的人），并在可能的情况下提供或安排密集的行为支持伴随NRT。这个建议是保守的，但希望能消除戒烟顾问和其他健康专业人员在考虑对有CVD病史的人使用NRT时所面临的一些障碍。
The causal relationship between cigarette smoking and cardiovascular disease (CVD) is well known and it is of great importance that smokers with CVD are encouraged to stop. Nicotine replacement therapy (NRT) is an effective aid to smoking cessation. However, its use in patients with CVD is often avoided because of warnings on product labelling. This is not justified, as NRT use in dependent smokers is much safer than smoking. Arguments are presented for the following guidelines which may be used when recommending NRT to patients with CVD; (i) NRT can normally be recommended to smokers with CVD who tried and failed to quit without such help; (ii) in patients who have experienced a serious cardiovascular event within the past 4 weeks, involve the patient's consulting physician. In less acute cases this is not needed; (iii) ensure dosing does not exceed the manufacturer's recommendation; (iv) warn patients to stop using NRT if they relapse to smoking; and (v) target motivated smokers (i.e. those seeking help), and where possible provide or arrange intensive behavioural support to accompany NRT. This advice is conservative, but will hopefully remove some obstacles faced by smoking cessation counsellors and other health professionals when considering the use of NRT in people with history of CVD.