Pre-Cessation Effects of Bupropion on Smoking

安非他酮对吸烟的戒烟前影响

• 批准号: 6967966
• 负责人: LARRY W HAWK
• 金额: $ 18.11万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-15 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6967966
• 关键词: behavior therapy; behavioral /social science research tag; breath tests; bupropion; clinical research; clinical trials; combination therapy; craving; drug abuse chemotherapy; drug administration rate /duration; group counseling; human subject; human therapy evaluation; interview; longitudinal human study; motivation; prognosis; questionnaires; relapse /recurrence; saliva; smoking cessation; tobacco abuse prevention

DESCRIPTION (provided by applicant): In clinical trials bupropion has been shown to double long-term smoking cessation rates. Nevertheless, most smokers using bupropion relapse back to smoking within the first few weeks of cessation. Bupropion has been hypothesized to help smokers to quit in part by reducing the reinforcing effects of smoking during the typical 1-week pre-quitting treatment phase. Learning theory and previous basic human and animal research support the hypothesis that a longer duration of bupropion treatment prior to the target quit date (TQD) will yield greater decreases in smoking satisfaction and the number of cigarettes smoked per day before quitting, and higher rates of continuous cessation after quitting. The proposed research is the first study of which we are aware to systematically vary the pre-quitting duration of bupropion treatment in smokers to test these predictions. A two group randomized experimental design will be used. One hundred male and female smokers who are motivated to quit smoking will be randomized to a brief run-in group (3 weeks of placebo, followed by the typical 1 week of pre-TQD bupropion) and an extended run-in group (4 weeks of pre-TQD bupropion). Both groups will receive 7 weeks of post-TQD bupropion, as well as group behavioral counseling for smoking cessation. During the pre-quitting treatment phase we predict that bupropion will reduce the number of cigarettes smoked daily and smoking satisfaction, relative to placebo. During a 3-month post-quitting phase, we predict that relapse will be lower in those who experience the greatest pre-quit reductions in smoking rate and satisfaction. We will conduct exploratory analyses of whether cessation is greater for subjects in the extended run-in group compared to the brief run-in group, and whether this effect is mediated by differences in the pre-quit effects of bupropion. This theory-based research may lead to enhanced treatment with bupropion and more broadly stimulate programmatic basic and clinical studies that improve cancer control through a better understanding of learning and behavioral processes implicated in pharmacotherapy for tobacco cessation.

描述（由申请人提供）：在临床试验中，安非他酮已被证明能使长期戒烟率翻倍。然而，大多数使用安非他酮的吸烟者在戒烟后的最初几周内又复发了。安非他酮被认为可以帮助吸烟者戒烟，部分原因是在典型的戒烟前一周治疗阶段，安非他酮可以减少吸烟的强化效应。学习理论和先前的基本人类和动物研究支持这样的假设，即在目标戒烟日期（TQD）之前较长的安非他酮治疗时间将导致吸烟满意度和戒烟前每天吸烟数量的更大下降，以及戒烟后持续戒烟率的更高。这项拟议的研究是我们所知的第一个系统地改变吸烟者戒烟前安非他酮治疗持续时间的研究，以测试这些预测。采用两组随机试验设计。100名积极戒烟的男性和女性吸烟者将被随机分为一个短期磨合组（3周安慰剂，随后是典型的1周tqd前安非他酮）和一个延长磨合组（4周tqd前安非他酮）。两组都将在tqd后接受7周的安非他酮治疗，以及戒烟的团体行为咨询。在戒烟前治疗阶段，我们预测，相对于安慰剂，安非他酮将减少每天吸烟的数量和吸烟满意度。在戒烟后的3个月里，我们预测那些戒烟前吸烟率和满意度下降幅度最大的人的复发率会更低。我们将对长期磨合组的受试者是否比短期磨合组的受试者戒烟效果更好进行探索性分析，以及这种效果是否由安非他酮戒烟前效果的差异介导。这项基于理论的研究可能会加强安非他酮的治疗，并更广泛地刺激纲领性的基础和临床研究，通过更好地了解与戒烟药物治疗有关的学习和行为过程来改善癌症控制。