NICOTINE REPLACEMENT FOR TREATMENT OF TOBACCO ADDICTION

使用含尼古丁的口香糖替代尼古丁是一种 迄今为止最有希望的吸烟成瘾治疗方法。 然而，还需要更多关于如何增加 尼古丁保乐力克斯口香糖的功效。必要的调查包括 重度依赖患者尼古丁-波拉西来斯的合适剂量问题 吸烟者VS依赖程度低的人。令人失望的戒烟率沉重 吸烟者给予2毫克似乎意味着更大的剂量应该用于 这样的吸烟者，但这个问题直到最近才开始研究。在……里面 此外，尼古丁口香糖的不同剂量可能会影响 戒毒率还需要进一步研究。此外，我们需要确定为什么 大多数吸烟者即使在提供尼古丁口香糖的情况下也会复发。 我们已经计划了一项多变量研究来解决这些问题。六百 吸烟者将根据依赖程度进行分类，高或低， 在基线时，然后随机分配到安慰剂口香糖或4毫克口香糖治疗。 治疗将包括仔细指导口香糖的使用，咨询 关于如何戒烟和保持禁欲，同情的社会支持， 并经常采取后续行动，监测进展情况。受试者将接受采访 在基线，停药后1天，停药后1周和2周，然后在1， 3个月、6个月、9个月和12个月。我们还将评估口香糖的使用量、 从口香糖使用中吸收的尼古丁、对口香糖的喜爱以及与口香糖相关的医疗 症状。此外，我们将评估动机，信心， 付出的努力，可用的社会支持，吸烟者的比例 受试者的环境，以及假设与之相关的其他因素 复发或禁欲，如年龄、性别和临床抑郁症。我们 还将衡量自我报告的戒断症状和客观指数 例如心脏、血压和体重。 这项研究应该为这一假设提供一个明确的、决定性的检验 增加尼古丁Polacrilex的剂量会增加 依赖型吸烟者。这项研究也应该增加我们对为什么 不同剂量的尼古丁可以提高(或不能提高)成功率， 以及我们对这些因素的理解，无论是独立的，还是通过 它们与剂量和依赖的相互作用，有助于复发和 禁欲。

Nicotine replacement using nicotine-containing chewing gum is one of the most promising treatment modalities to date for smoking addiction. However, much additional information is needed on how to increase the efficacy of nicotine polacrilex gum. Requisite investigations include the issue of appropriate dosages of nicotine polacrilex for heavily dependent smokers vs those low on dependence. Disappointing quit rates with heavy smokers given 2 mg seem to imply that larger dosages should be used for such smokers, but this issue has only recently begun to be studied. In addition, mechanisms whereby nicotine gum varying dosages may impact cessation rates need further study. Furthermore, we need to determine why the majority of smokers relapse even when provided nicotine gum. We have planned a multivariate study to address these issues. Six hundred smokers will be classified according to degree of dependence, high or low, at baseline, then randomly assigned to placebo gum, or 4 mg gum treatment. Treatment will consist of careful instruction in gum usage, counseling concerning how to quit and maintain abstinence, empathetic social support, and frequent follow-up to monitor progress. Subjects will be interviewed at baseline, 1 day post-cessation, 1 and 2 weeks post-cessation, then at 1, 3, 6, 9, and 12 months. We will also assess amount of gum used, amount of nicotine absorbed from gum use, liking for gum, and gum-related medical symptoms. Furthermore, we will evaluate degree of motivation, confidence, and effort expended, social supports available, proportion of smoker's in the subject's environment, and other factors hypothesized to be related to relapse or abstinence such as age, gender, and clinical depression. We will also measure self-reported withdrawal symptoms, and objective indices such as heart, blood pressure, and body weight. This study should provide a clear, definitive test of the hypothesis that increasing the dosage of nicotine polacrilex increases abstinence rates for dependent smokers. The study should also increase our understanding of why varying the dose of nicotine enhances (or fails to enhance) success rates, and our comprehension of factors which, either independently, or through their interactions with dosage and dependence, contribute to relapse and abstinence.