Does Extended Pre Quit Bupropion Aid in Extinguishing Smoking Behavior?
Does Extended Pre Quit Bupropion Aid in Extinguishing Smoking Behavior?
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DOI：
10.1093/ntr/ntu347
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发表时间：
2015-11-01
影响因子：
4.7
通讯作者：
Mahoney, Martin C.
中科院分区：
文献类型：
--
作者：
Hawk, Larry W., Jr.;Ashare, Rebecca L.;Mahoney, Martin C.
了解安非他酮促进戒烟的机制可能会导致更有效的治疗。在某种程度上，减少吸烟强化是一种这样的机制，戒烟前安非他酮治疗的持续时间较长，应促进吸烟行为的消除。我们评估了4周的戒烟前安非他酮是否（延长磨合期）导致戒烟前吸烟率和可替宁的减少，其次是短期戒烟率比标准戒烟前1周的安非他酮更高（标准导入期）。（n = 95; 48名女性）被随机分配到标准导入组（n = 48; 3周安慰剂，然后戒烟前1周安非他酮）或延长导入组（戒烟前4周安非他酮; n = 47）。两组均接受团体行为辅导和戒烟后7周的安非他酮治疗。在戒烟前期间每天收集吸烟率（和渴望、戒断和主观效应）;在研究访视时收集生化数据（可替宁和一氧化碳）。在戒烟前期间，与标准导入组相比，延长导入组表现出吸烟率更大的下降，相互作用p = 0.03。吸烟欲望和唾液可替宁遵循类似的模式，尽管后者仅在女性中明显。生化证实的4周连续戒烟率在延长导入组（53%）高于标准导入组（31%），p = 0.033。戒烟前延长使用安非他酮可减少戒烟前的吸烟行为，提高短期戒烟率。这些数据是一致的，与一个强化模型，并支持进一步调查延长运行在安非他酮戒烟治疗。
Understanding the mechanisms by which bupropion promotes smoking cessation may lead to more effective treatment. To the extent that reduced smoking reinforcement is one such mechanism, a longer duration of pre quit bupropion treatment should promote extinction of smoking behavior. We evaluated whether 4 weeks of pre quit bupropion (extended run-in) results in greater pre quit reductions in smoking rate and cotinine and, secondarily, greater short-term abstinence, than standard 1 week of pre quit bupropion (standard run-in).Adult smokers (n = 95; 48 females) were randomized to a standard run-in group (n = 48; 3-week placebo, then 1-week bupropion pre quit) or an extended run-in group (4-week pre quit bupropion; n = 47). Both groups received group behavioral counseling and 7 weeks of post quit bupropion. Smoking rate (and craving, withdrawal, and subjective effects) was collected daily during the pre quit period; biochemical data (cotinine and carbon monoxide) were collected at study visits.During the pre quit period, the extended run-in group exhibited a greater decrease in smoking rate, compared to the standard run-in group, interaction p = .03. Cigarette craving and salivary cotinine followed a similar pattern, though the latter was evident only among women. Biochemically verified 4-week continuous abstinence rates were higher in the extended run-in group (53%) than the standard run-in group (31%), p = .033.The extended use of bupropion prior to a quit attempt reduces smoking behavior during the pre quit period and improved short-term abstinence rates. The data are consistent with an extinction-of-reinforcement model and support further investigation of extended run-in bupropion therapy for smoking cessation.