Effects of immediate versus gradual nicotine reduction in cigarettes on biomarkers of biological effects
Effects of immediate versus gradual nicotine reduction in cigarettes on biomarkers of biological effects
复制标题
DOI：
10.1111/add.14695
复制
发表时间：
2019-07-08
期刊：
影响因子：
6
通讯作者：
Hecht, Stephen S.
中科院分区：
文献类型：
--
作者：
Hatsukami, Dorothy K.;Luo, Xianghua;Hecht, Stephen S.
目的：先前的一项研究表明，与随着时间的推移逐渐减少或继续吸烟正常尼古丁含量的香烟相比，吸烟者立即将香烟中的尼古丁减少到非常低的水平，吸烟的香烟数量和有毒物质和致癌物质暴露的生物标志物显着减少。本研究考察了这些方法对与有害生物效应相关的选定生物标志物的影响。设计三组随机对照试验。设置10个美国学术机构网站。参与者每日吸烟者对戒烟不感兴趣，平均年龄为45.1 [标准差（SD）= 13.4）]岁，吸烟17.1（SD = 8.5）支/天; 43.9%（549/1250）女性; 60.6%（758/1250）白色种族。干预措施：（1）吸烟，尼古丁含量立即降低到非常低的水平（n = 503）;（2）吸烟，尼古丁含量逐渐降低，每月发生剂量变化（n = 498）;（3）继续吸烟，尼古丁含量正常的香烟（n = 249）。吸烟者在基线时吸烟，并在第4、8、12、16和20周再次进行评估。结果是炎症、氧化应激和血液学参数的生物标志物的研究期间的浓度时间曲线下面积（AUC）。结果：各组之间未观察到一致的显著差异（贝叶斯因子显示数据不敏感），唯一的例外是红细胞大小变异性，观察到其在立即与逐渐尼古丁减少中较低[平均差异= -0.11; 95%可信区间（CI）=-0.18，-0.04，P = 0.004]和正常尼古丁对照组（均数差异=-0.15，95%CI =-0.23，-0.06，P = 0.001）。目前尚不清楚改用尼古丁含量极低的香烟是否会导致烟草相关危害的生物标志物短期减少。
Aim A previous study showed significantly greater reductions in number of cigarettes smoked and biomarkers of toxicant and carcinogen exposure in smokers assigned to immediate reduction of nicotine in cigarettes to very low levels versus gradually over time or continued smoking of normal nicotine content cigarettes. This study examines the effects of these approaches on selected biomarkers associated with harmful biological effects. Design Three-arm, randomized controlled trial. Setting Ten United States academic institutional sites. Participants Daily smokers uninterested in quitting smoking with a mean age of 45.1 [standard deviation (SD) = 13.4)] years and smoking 17.1 (SD = 8.5) cigarettes/day; 43.9% (549 of 1250) female; 60.6% (758 of 1250) white ethnicity. Interventions (1) Smoking cigarettes where nicotine content was immediately reduced to very low levels (n = 503); (2) smoking cigarettes where nicotine content was gradually reduced, with dose changes occurring monthly (n = 498); and (3) continued smoking with normal nicotine content cigarettes (n = 249). Measurements Smokers were assessed at baseline while smoking their usual brand cigarettes, and again at 4, 8, 12, 16 and 20 weeks. Outcomes were areas under the concentration time curve (AUC) for the period of study of biomarkers of inflammation, oxidative stress and hematological parameters. Findings No consistent significant differences were observed across groups (Bayes factors showing data to be insensitive), with the only exception being red blood cell size variability, which was observed to be lower in the immediate versus gradual nicotine reduction [mean difference = -0.11; 95% confidence interval (CI) = -0.18, -0.04, P = 0.004] and normal nicotine control groups (mean difference = - 0.15, 95% CI = -0.23, -0.06, P = 0.001). Conclusion It remains unclear whether switching to very low nicotine cigarettes leads to a short-term reduction in biomarkers of tobacco-related harm.