Lack of attentional retraining effects in cigarette smokers attempting cessation: a proof of concept double-blind randomised controlled trial.
Lack of attentional retraining effects in cigarette smokers attempting cessation: a proof of concept double-blind randomised controlled trial.
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DOI：
10.1016/j.drugalcdep.2015.01.041
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发表时间：
2015-04-01
影响因子：
4.2
通讯作者：
Aveyard P
中科院分区：
文献类型：
--
作者：
Begh R;Munafò MR;Shiffman S;Ferguson SG;Nichols L;Mohammed MA;Holder RL;Sutton S;Aveyard P
观察性研究表明，对吸烟相关线索的注意力偏差与吸烟渴望增加和复吸有关。实验室实验表明，操纵注意力偏差可能会改变渴望。减少注意力偏差的干预措施可以减少寻求戒烟的吸烟者的复吸。我们报告了一项针对寻求治疗的吸烟者进行注意力再训练的临床试验。这是在英国戒烟诊所进行的一项双盲随机对照试验。对戒烟感兴趣的吸烟者在戒烟日前一周随机接受五次每周一次的注意力再训练（N=60）或安慰剂训练（N=58），使用改良的视觉探测任务。两组均接受 21 毫克尼古丁贴片（从戒烟日起）和行为支持。主要结果包括视觉探测任务戒烟日四周后注意力偏差反应时间的变化，以及每周使用情绪和身体症状量表测量的渴望。次要结果是戒断症状的变化、首次戒断时间和延长戒断时间。基线时的样本中未发现对吸烟线索的注意偏差（平均差 = 3 毫秒，95% CI = -2, 9）。与安慰剂组相比，再训练组的训练后偏差并未显着降低（平均差=-9 ms，95% CI=-20, 2）。各组之间在渴望变化（p = 0.89）和四周时长期戒断（风险比= 1.00，95％CI = 0.70，1.43）方面没有差异。与另一项试验相比，使用视觉探测任务进行基于临床的注意力再训练似乎没有效果。在诊所外进行的注意力再训练可能会更有效。英国临床试验 ISRCTN 54375405。
Observational studies have shown that attentional bias for smoking-related cues is associated with increased craving and relapse. Laboratory experiments have shown that manipulating attentional bias may change craving. Interventions to reduce attentional bias could reduce relapse in smokers seeking to quit. We report a clinical trial of attentional retraining in treatment-seeking smokers. This was a double-blind randomised controlled trial that took place in UK smoking cessation clinics. Smokers interested in quitting were randomised to five weekly sessions of attentional retraining (N=60) or placebo training (N=58) using a modified visual probe task from one week prior to quit day. Both groups received 21 mg nicotine patches (from quit day onwards) and behavioural support. Primary outcomes included change in attentional bias reaction times four weeks after quit day on the visual probe task and craving measured weekly using the Mood and Physical Symptoms Scale. Secondary outcomes were changes in withdrawal symptoms, time to first lapse and prolonged abstinence. No attentional bias towards smoking cues was found in the sample at baseline (mean difference=3 ms, 95%CI=-2, 9). Post-training bias was not significantly lower in the retraining group compared with the placebo group (mean difference=-9 ms, 95%CI=-20, 2). There was no difference between groups in change in craving (p=0.89) and prolonged abstinence at four weeks (risk ratio=1.00, 95%CI=0.70, 1.43). Taken with one other trial, there appears to be no effect from clinic-based attentional retraining using the visual probe task. Attentional retraining conducted out of clinic may prove more effective. UK Clinical Trials ISRCTN 54375405.