SMOKING WITHDRAWAL EFFECTS ON ENERGY BALANCE

吸烟者的体重比不吸烟者轻，通常会增加5-10磅。在 戒烟，但尼古丁影响身体的机制 重量仍不清楚。本研究的主要目的是(1) 描述短期和长期的代谢和体重变化 戒烟所致，(2)评估不同水平的效果 无味觉尼古丁替代对这些影响的影响，(3)测试二 尼古丁在人体内作用的特定模型(调节与效应) 体重调节，(4)确定低代谢的程度 有助于烟草戒断综合症的严重程度，以及(5)测试 节制的饮食方式是否会使人面临增加的风险 体重增加和戒断严重程度。75名吸烟者将被随机分配 三组中的一组(根据限制进食进行分层 分数)：44毫克尼古丁替代品，22毫克尼古丁替代品，或安慰剂。 受试者将接受为期6周的尼古丁贴片治疗和强化治疗 团体咨询16周。静息代谢率(RMR)，体温 对食物的反应，戒断评分，3天饮食记录， 尼古丁/可替宁水平和活性将在一夜之间进行评估 (12小时)戒烟前和24小时内进行热量测量 停药后1周、4周、8周和16周的量热法。如果44毫克 尼古丁的剂量足以维持吸烟前的戒烟设定点， 在戒烟后1周和4周，44 mg组应该有更高的RMR和 卡路里摄入量低于其他组。22毫克组的体重应该是 超过44毫克组的16周。RMR的下降应该是强劲的 与戒断严重程度的增加有关，而那些患有 节制的饮食方式应该表现出最大的卡路里增加 RMR的摄入量、体重和下降。除了提供强大的 两种理论的检验，本研究也具有很大的临床意义。 这可能有助于识别哪些吸烟者体重增加的风险最大， 并提出了管理与吸烟有关的体重增加的最佳策略 停止。由于对体重增加的恐惧阻止了许多吸烟者尝试 戒掉，这些信息可能会提供显著的健康益处。

Smokers weigh less than nonsmokers, and typically gain 5-10 lbs. upon quitting smoking, yet the mechanisms by which nicotine influences body weight remain unclear. The chief aims of this research are to (1) characterize the short- and long-term metabolic and weight changes resulting from smoking cessation, (2) assess the effect of various levels of non-orosensory nicotine replacement on these effects, (3) test two specific models (regulatory vs. effector) of nicotine's role in human weight regulation, (4) determining the degree to which hypometabolism contributes to tobacco withdrawal syndrome severity, and (5) testing whether a restrained eating style places persons at risk for increased weight gain and withdrawal severity. 75 smokers will be randomly assigned to one of three groups (stratified on the basis of a restrained eating score): 44mg nicotine replacement, 22 mg nicotine replacement, or Placebo. Subjects will receive nicotine patch therapy for 6 weeks and intensive group counseling for 16 wks. Resting metabolic rate (RMR), thermic response to food, withdrawal ratings, 3 day dietary records, nicotine/cotinine levels, and activity will be assessed in an overnight (12 hr) calorimetry session prior to smoking cessation, and in 24 hr calorimetry sessions 1, 4, 8 & 16 wks post-cessation. If the 44 mg nicotine dose is sufficient to maintain pre-smoking cessation set-point, at 1 and 4 wks post-quit the 44 mg group should have a higher RMR and lower caloric intake than the other groups. The 22 mg group should weigh more than the 44 mg group by wk 16. Decline in RMR should be strongly associated with increased withdrawal severity, and those subjects with restrained eating styles should show the greatest increases in caloric intake, weight, and decline in RMR. In addition to providing a powerful test of two theories, this research also has great clinical significance. It may help to identify those smokers at greatest risk for weight gain, and suggest optimal strategies for managing weight gain related to smoking cessation. As fear of weight gain deters many smokers from attempting to quit, this information could provide significant health benefits.