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比较电子烟和尼古丁替代疗法的随机试验
A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy


Peter Hajek ... 其他 • 2019.02.14
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• 电子烟与尼古丁替代疗法协助戒烟的比较 • 在戒烟试验中,现金奖励的效果优于免费药物

摘要


背景

电子烟常用于戒烟,但与已批准的尼古丁产品戒烟疗法进行比较的疗效证据有限。

 

方法

我们将参加英国国民保健服务(National Health Service)戒烟计划的成人随机分组,使用他们选择的尼古丁替代品(包括产品组合)长达3个月,或者使用电子烟新手包(第二代可重复添加烟油的电子烟,配备一瓶尼古丁电子烟烟油[18 mg/mL]),并建议自行选择口味和浓度,另行购买电子烟烟油。治疗包括至少4周的每周行为支持。主要结局为1年持续戒烟(经最后一次访视时的生化检测结果确定)。失访或未提供生化验证结果的参与者被视为未戒烟。次要结局包括参与者报告的治疗方法使用情况和呼吸系统症状。

 

结果

总共886例参与者被随机分组。在电子烟组和尼古丁替代组中,1年戒烟率分别为18.0%和9.9%(相对危险度,1.83;95%置信区间[CI],1.30~2.58;P<0.001)。在戒烟1年的参与者中,与尼古丁替代组参与者相比,电子烟组参与者较可能在52周时使用分配的产品(9%[44例参与者中的4例] vs. 80%[79例参与者中的63例])。总体上,电子烟组的喉部和口腔刺激发生率较高(65.3% vs.尼古丁替代组的51.2%),尼古丁替代组的恶心发生率较高(37.9% vs.电子烟组的31.3%)。从基线至52周,电子烟组咳嗽和痰液产生的发生率降幅大于尼古丁替代组(咳嗽的相对危险度,0.8;95% CI,0.6~0.9;痰液产生的相对危险度,0.7;95% CI,0.6~0.9)。哮鸣或呼吸急促的发生率无显著组间差异。

 

结论

当两种方法均联合行为支持治疗时,电子烟的戒烟效果优于尼古丁替代疗法(由英国国家卫生研究院[National Institute for Health Research]和英国癌症研究所[Cancer Research UK]资助;在Current Controlled Trials注册号为ISRCTN60477608)。





作者信息

Peter Hajek, Ph.D., Anna Phillips-Waller, B.Sc., Dunja Przulj, Ph.D., Francesca Pesola, Ph.D., Katie Myers Smith, D.Psych., Natalie Bisal, M.Sc., Jinshuo Li, M.Phil., Steve Parrott, M.Sc., Peter Sasieni, Ph.D., Lynne Dawkins, Ph.D., Louise Ross, Maciej Goniewicz, Ph.D., Pharm.D., Qi Wu, M.Sc., and Hayden J. McRobbie, Ph.D.
From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King’s College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) — all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.). Address reprint requests to Dr. Przulj at Queen Mary University of London, Health and Lifestyle Research Unit, 2 Stayner’s Rd., London E1 4AH, United Kingdom, or at d.przulj@qmul.ac.uk.

 

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