Mediating mechanisms for the impact of bupropion in smoking cessation treatment
Mediating mechanisms for the impact of bupropion in smoking cessation treatment
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DOI：
10.1016/s0376-8716(02)00067-4
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发表时间：
2002-07-01
影响因子：
4.2
通讯作者：
Epstein, L
中科院分区：
文献类型：
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作者：
Lerman, C;Roth, D;Epstein, L
有几项研究证明了安非他酮对戒烟的有效性，但对其促进戒烟的机制知之甚少。在这项安慰剂对照的随机试验中。我们研究了安非他酮对戒断的影响是否通过戒断和/或消极或积极影响(PA)的变化来调节。251名吸烟者接受了为期10周的安非他酮或安慰剂治疗，外加行为咨询。在结构方程模型中，从戒烟前到戒断后1周的情感和戒断症状的变化被作为中介变量。在治疗结束时(停药后8周)，经可替宁验证的7天时点患病率停止率安非他酮为48%，安慰剂为29%(P=0.001)。在戒断和负性情绪(NA)方面有显著的治疗效果；然而，只有NA的变化预示着戒断。在PATH模型中，NA的变化是安非他酮戒断效果的重要中介。然而，这个中介变量解释的变异比例很小，这表明其他未测量的因素发挥了重要作用。以实验室为基础的范例可能有助于确定安非他酮效果的其他介体，从而指出可以在未来的治疗研究中支持的作用机制。(C)2002年，爱思唯尔科学爱尔兰有限公司出版。
Several studies have documented the effectiveness of bupropion for smoking cessation, yet little is known about the mechanisms by which it facilitates abstinence. In this placebo-controlled randomized trial. We examined whether bupropion's effects on cessation were mediated by changes in withdrawal and/or negative or positive affect (PA). Two hundred and fifty-one smokers received 10-week treatment with bupropion or placebo, plus behavioral counseling. Changes in affect and withdrawal symptoms from pre-quit to 1 week post quit were examined as mediating variables in structural equation models. Cotinine-verified 7-day point prevalence cessation rates at the end of treatment (8-weeks post quit date) were 48% for bupropion and 29% for placebo (P = 0.001). There were significant treatment effects on withdrawal and negative affect (NA); however, only change in NA predicted cessation. In a path model, change in NA was a significant mediator of bupropion's effects on cessation. However, the proportion of variance accounted for by this mediator was small, suggesting that other unmeasured factors play an important role. Laboratory-based paradigms may be useful to identify other mediators of bupropion's effects, thereby pointing to mechanisms of effect that can be bolstered in future treatment studies. (C) 2002 Published by Elsevier Science Ireland Ltd.