Smoking reduction fails to improve clinical and biological markers of cardiac disease: A randomized controlled trial
Smoking reduction fails to improve clinical and biological markers of cardiac disease: A randomized controlled trial
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DOI：
10.1080/14622200801901948
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Hatsukami, Dorothy K.
中科院分区：
文献类型：
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作者：
Joseph, Anne M.;Hecht, Stephen S.;Hatsukami, Dorothy K.
减少吸烟已被提议作为对完全戒烟不感兴趣的吸烟者的治疗目标。这项随机对照试验旨在确定减少吸烟干预对吸烟行为、心脏病症状和烟草暴露生物标志物的影响。其中包括152名心脏病患者，他们不打算在接下来的30天内戒烟。参与者被随机分配到戒烟组(SR)或常规护理组(UC)。老年受试者接受咨询和尼古丁替代疗法，以鼓励每天减少50%的香烟(CPD)。分别于1、3、6、12和18个月随访，评估吸烟、心脏病症状、生活质量和尼古丁、可替宁、一氧化碳(CO)、白细胞(WBC)计数、纤维蛋白原、超敏C反应蛋白(hs-C-CRP)、F-2-异前列腺素、4-(甲基亚硝基)-1-(3-吡啶)-1-丁醇及其葡萄糖醛酸苷(总NNAL)和1-羟基芘(1-HOP)。在6个月时，SR参与者减少了10.9CPD，而UC组减少了7.4CPD(差异NS)。在18个月时，9/78 SR与9/74 UC参与者戒烟。两组在心绞痛、生活质量或不良事件、尼古丁、可替宁、CO、WBC计数、纤维蛋白原、hs-CRP、F-2-异前列腺素、总NNAL或1-HOP水平上均无显著差异。为了确定无论治疗条件如何，减少吸烟是否与改善预后有关，我们比较了所有受试者在6个月后与基线的关系(CPD从27.4平均减少到18.1，p
Cigarette reduction has been proposed as a treatment goal for smokers who are not interested in stopping completely. This randomized controlled trial was designed to determine the effect of a smoking reduction intervention on smoking behavior, symptoms of heart disease, and biomarkers of tobacco exposure. It included 152 patients with heart disease who did not intend to stop smoking in the next 30 days. Participants were randomly assigned to smoking reduction (SR) or usual care (UC). SR subjects received counseling and nicotine replacement therapy to encourage >= 50% reduction in cigarettes per day (CPD). They were followed at 1, 3, 6, 12 and 18 months to assess smoking, heart disease symptoms, quality of life and nicotine, cotinine, carbon monoxide (CO), white blood cell (WBC) count, fibrinogen, hs-C-reactive protein (hs-CRP), F-2-isoprostane, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), and 1-hydroxypyrene (1-HOP). At 6 months SR participants reduced by 10.9 CPD, compared with 7.4 CPD in UC (difference NS). At 18 months, 9/78 SR vs. 9/74 UC participants quit smoking. There were no significant differences between treatment groups in angina, quality of life or adverse events, nicotine, cotinine, CO, WBC count, fibrinogen, hs-CRP, F-2-isoprostane, total NNAL or 1-HOP levels at any time point. To determine if smoking reduction, regardless of treatment condition, was associated with improved outcomes, we compared all subjects at 6 months to baseline (mean reduction in CPD from 27.4 to 18.1, p