Effects of cigarette reduction on cardiovascular risk factors and subjective measures
Effects of cigarette reduction on cardiovascular risk factors and subjective measures
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DOI：
10.1378/chest.128.4.2528
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发表时间：
2005-10-01
期刊：
影响因子：
9.6
通讯作者：
Murphy, S
中科院分区：
文献类型：
--
作者：
Hatsukami, DK;Kotlyar, M;Murphy, S
研究目的：评估持续吸烟和减少吸烟对心血管生物标志物的影响（例如，白细胞计数、胆固醇浓度、血压、心率）。设计、设置和参与者：这项在明尼苏达大学进行的研究，将有兴趣显著减少吸烟但不戒烟的吸烟者随机分为两组，一组立即开始12周的戒烟（n = 102），尼古丁替代疗法辅助，或6周等待名单（n = 49）。那些开始减少吸烟的人被要求在2周内减少25%的吸烟量，在2周内减少50%，在最后2周内减少75%。6周后，受试者被要求保持50%的减少或退出。使用尼古丁口香糖，必要时使用尼古丁贴片来实现减少目标。等候名单组（n = 49）吸烟6周，然后减少吸烟如前所述。测量和结果：心血管生物标志物（如，白细胞计数，胆固醇浓度，血压，心率）进行了评估，在几个时间点后登记。在随意吸烟期间，心血管生物标志物保持相对稳定，在各种时间测量中的相关系数范围为0.44至1.00（所有测量的p < 0.01）。在成功的非禁欲还原者中，（151名受试者中的64名），在许多生物标志物中发现了显著改善（如血红蛋白、红细胞压积、RBC和WBC计数、血脂、血压、心率、呼吸道症状，所有p < 0.0167）。这些结果表明，可靠和剂量的可用性-在健康的吸烟者中，减少吸烟可导致心血管危险因素的显著但仅适度的变化。目前尚不清楚减少吸烟后观察到的心血管危险因素的减少是否也与疾病风险降低有关。需要进行更多的研究来解决这个问题。
Study objectives: To assess the effect of continued smoking and smoking reduction on cardiovascular biomarkers (eg, WBC count, cholesterol concentrations, BP, heart rate).Design, setting, and participants: This study, conducted at the University of Minnesota, randomized smokers interested in significantly reducing cigarette use but not quitting to either start 12 weeks of smoking reduction immediately (n = 102), assisted by nicotine replacement therapy, or to a 6-week wait list (n = 49). Those starting smoking reduction were required to reduce smoking by 25% for 2 weeks, 50% for 2 weeks, and 75% during the final 2 weeks. After 6 weeks, the subjects were asked to maintain a 50% reduction or quit. Nicotine gum and, if necessary, nicotine patch were used to achieve reduction goals. The wait list group (n = 49) smoked ad libitum for 6 weeks and then reduced smoking as previously described.Measurements and results: Cardiovascular biomarkers (eg, WBC count, cholesterol concentrations, BP, heart rate) were assessed at several time points after enrollment. During ad libitum smoking, cardiovascular biomarkers remained relatively stable with correlation coefficients across the various time measurements, ranging from 0.44 to 1.00 (p < 0.01 for all measures). Among successful nonabstinent reducers (64 of 151 subjects), significant improvements were found in many biomarkers (eg, hemoglobin, hematocrit, RBC and WBC counts, lipids, BP, heart rate, respiratory symptoms, all p < 0.0167).Conclusions: These results show the availability of reliable and dose-sensitive biomarkers and that reduction in smoking can lead to significant but only modest changes in cardiovascular risk factors in healthy smokers. It is not known whether the reductions in cardiovascular risk factors observed after smoking reduction are also associated with reduced disease risk. Additional research is necessary to address this issue.