Achieving Smoking Cessation Among Persons with Opioid Use Disorder.
Achieving Smoking Cessation Among Persons with Opioid Use Disorder.
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DOI：
10.1007/s40263-020-00701-z
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发表时间：
2020-04
期刊：
影响因子：
6
通讯作者：
Nahvi S
中科院分区：
文献类型：
--
作者：
Vlad C;Arnsten JH;Nahvi S
虽然美国普通人群的烟草使用率正在下降，但阿片类药物使用障碍（OUD）患者的患病率仍然很高，并导致过度的烟草相关疾病和过早死亡。在患有OUD的吸烟者中，如果不进行治疗，戒烟率可以忽略不计。然而，无论是低强度的行为干预和更密集的动机干预产生的戒烟率可以忽略不计。虽然应急管理具有强大的短期戒烟效果，但在干预后的随访中效果并不维持。循证戒烟药物治疗，如尼古丁替代疗法，安非他酮和伐尼克兰，导致OUD吸烟者的戒烟率非常低。与标准治疗方案相比，强化药物治疗（如高剂量和联合尼古丁替代治疗或扩展药物治疗）未能改善戒烟结局。针对OUD吸烟者面临的独特挑战，包括尼古丁-阿片类药物相互作用和药物依从性差，有可能改善戒烟结果，但需要进一步研究来优化OUD吸烟者的干预效果。
While prevalence of tobacco use in the U.S. general population is declining, prevalence among persons with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared to standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine-opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.
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