Jaqueline R Scholz, Bianca B Bellini, Sara D V Ziotti, Tania O Abe, Debora Arnaut, Rodrigo L Alberto, Marco A Marcolin, Serena Tonstad
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引用次数: 0
摘要
提示限制吸烟（CRS）是一种戒烟的行为技术，作为药物治疗的辅助手段已经显示出疗效。在CRS中，个体在没有感官刺激的孤立环境中，面对墙壁站着吸烟。本研究旨在评估CRS在一项评估深经颅磁刺激（dTMS）的随机试验中的潜在影响，该试验未显示出显著的治疗效果。方法：在一项评估dTMS戒烟效果的随机、双盲、假对照试验中，100名参与者被指示在第一周结束前戒烟。没有人成功戒烟。只有85名参与者在第1周后继续遵守协议，并在渴望期间接受了实施CRS的指导。通过自我报告、呼出一氧化碳（COex）和血浆可替宁水平监测吸烟情况。参与者被分类为：不减少、进一步减少或停止。接合点回归用于评估纵向趋势。结果：85名参与者（68%为男性，平均年龄49±11.6岁）报告的平均吸烟时间为31±11.2年。在第一周之后，33%的人没有减少饮酒量，8%的人轻度减少，43%的人适度减少，15%的人显著减少；没有人成功戒烟。在CRS后，40% （95% CI: 29.5-51.2）报告了进一步的减少，16.5% （95% CI: 9.3-26.1）在第12周达到了证实的戒烟。联合点分析证实，在显著减少和戒烟组中，卷烟使用和COex有显著下降趋势。结论：CRS与临床有意义的吸烟减少和生化证实的戒烟有关。这是一种低成本、可扩展的技术，不需要强化培训或药物治疗。这种方法在资源匮乏的环境中可能是有利的。它值得在不同人群中进行更大规模的随机试验来评估。临床试验注册：本研究在ClinicalTrials.gov.Identifier: ID NCT03264313的官方网站注册。
Cue-Restricted Smoking as a behavioral adjunct for smoking cessation: Observational sub-analysis of a randomized trial of deep transcranial magnetic stimulation.
Introduction: Cue-Restricted Smoking (CRS) is a behavioral technique for smoking cessation that has shown efficacy as an adjunct to pharmacotherapy. In CRS, individuals limit smoking to a standing position while facing a wall in an isolated environment devoid of sensory stimulation. This study aimed to assess the potential impact of CRS in a randomized trial evaluating deep transcranial magnetic stimulation (dTMS), which failed to show significant treatment effects.
Methods: In a randomized, double-blind, sham-controlled trial evaluating dTMS for smoking cessation, 100 participants were instructed to quit smoking by the end of week 1. None achieved cessation. Only 85 participants remained in the protocol beyond week 1 and received guidance to implement CRS during cravings. Cigarette consumption was monitored through self-report, exhaled carbon monoxide (COex), and plasma cotinine levels. Participants were categorized as: no reduction, additional reduction, or cessation. Joinpoint regression was used to assess longitudinal trends.
Results: The 85 participants (68% male; mean age 49 ± 11.6 years) reported a mean of 31 ± 11.2 years of smoking. Beyond week one, 33% had not reduced their consumption, 8% showed a mild reduction, 43% a moderate reduction, and 15% a significant reduction; none achieved cessation. After CRS, 40% (95% CI: 29.5-51.2) reported further reduction, and 16.5% (95% CI: 9.3-26.1) achieved verified cessation by week 12. Joinpoint analysis confirmed significant decreasing trends in cigarette use and COex among the significant reduction and cessation groups.
Conclusions: CRS was associated with clinically meaningful reductions in smoking and biochemically confirmed cessation. It is a low-cost, scalable technique that does not require intensive training or pharmacotherapy. This approach may be advantageous in low-resource settings. It warrants evaluation in larger randomized trials across diverse populations.
Clinical trial registration: The study is registered on the official website of ClinicalTrials.gov.
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