Treating Smokers in Substance Treatment With Contingent Vouchers, Nicotine Replacement and Brief Advice Adapted for Sobriety Settings.
Treating Smokers in Substance Treatment With Contingent Vouchers, Nicotine Replacement and Brief Advice Adapted for Sobriety Settings.
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通过应有的代金券，尼古丁的替代品和简短的建议，适合清醒设置，以药物治疗治疗吸烟者。
DOI：
10.1016/j.jsat.2016.08.012
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发表时间：
2017-01
影响因子：
3.9
通讯作者：
Monti, Peter M.
中科院分区：
文献类型：
--
作者：
Rohsenow, Damaris J.;Martin, Rosemarie A.;Tidey, Jennifer W.;Colby, Suzanne M.;Monti, Peter M.
关键词：
物质使用障碍（SUD）的治疗提供了一个机会，使用基于凭证的治疗吸烟。尼古丁替代（NRT）可以改善以前观察到的无NRT代金券的结果。一项随机对照试验比较了条件戒烟者（CV）和非条件戒烟者（NV）的戒烟效果，所有人都接受了咨询和NRT。在住宅SUD治疗中未寻求吸烟治疗的吸烟者（n = 340），在5天的吸烟减少期后，为每个呼出的一氧化碳（CO）提供14天的完全戒烟券，或仅提供呼气样本的券，加上简短的建议（四次会议）和8周的NRT。在治疗期间，20%的CV患者完全戒断，5%的NV患者完全戒断（p < .001），CV患者戒断天数为50%，NV患者为22%（p < .001）。在随机化后的1、3、6和12个月，CV导致每天吸烟量显著减少（p < .01），吸烟天数显著减少（p < .01），但影响较小。随访期间的点患病率禁欲差异（例如，在6个月和12个月时，NV的CV为4%，2%）不显著。在物质使用方面没有发现差异。治疗内对戒断的影响强于先前使用BA但未使用NRT的相同CV研究，但NRT在代金券结束后并未改善戒断。基于凭证的治疗的影响包括调查与更强的吸烟药物和使用动机访谈相结合时的效果。吸烟治疗不会损害SUD的恢复。
Treatment for substance use disorders (SUD) provides an opportunity to use voucher-based treatment for smoking. Nicotine replacement (NRT) could improve outcomes previously observed with vouchers without NRT. A randomized controlled trial compared Contingent Vouchers (CV) for smoking abstinence to Noncontingent Vouchers (NV), when all received counseling and NRT. Smokers who had not sought smoking treatment (n = 340) in residential SUD treatment were provided 14 days of vouchers for complete smoking abstinence per exhaled carbon monoxide (CO) after a 5-day smoking reduction period, or vouchers only for breath samples, plus Brief Advice (four sessions) and 8 weeks of NRT. Within treatment, 20% had complete abstinence with CV, 5% with NV (p < .001), and participants showed 50% of days abstinent in CV compared to 22% in NV (p < .001). Across 1, 3, 6 and 12 months after randomization, CV resulted in significantly fewer cigarettes per day (p < .01) and fewer days smoking (p < .01), but with small effects. Point-prevalence abstinence differences across follow-up (e.g., 4% CV, 2% in NV at 6 and 12 months) were not significant. No differences in substance use were seen. Within-treatment effects on abstinence are stronger than in a prior study of the same CV with BA but without NRT, but NRT does not improve abstinence after vouchers end. Implications for voucher-based treatment include investigating effects when combined with stronger smoking medications and using motivational interviewing. Smoking treatment does not harm SUD recovery.
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