戒煙會增加感冒症狀與口腔潰瘍的機會


  Feb. 27, 2003 - 發表於2月份「煙草管制(Tobacco Control)」雜誌的一項前瞻性研究中,首度有系統地指出,戒煙會明顯增加感冒症狀與口腔潰瘍的機會,因此研究人員認為告知患者這些可能的情形將可提高他們戒煙成功的機率。
  
  倫敦醫學院St. George's醫院Michael Ussher博士表示,吸煙者需要被告知,如果他們開始戒煙,就可能會增加感冒症狀與口腔潰瘍的機會,這樣的心理準備可以讓他們在戒煙的過程中減少一些不必要的衝擊或影響。
  
  Ussher博士結合行為支持法與尼古丁貼片為174位吸煙者進行為期7週的戒煙計畫,其中約2/3為女性,平均年齡為43歲,他們的煙齡都至少有3年以上,平均每天要吸1包煙。
  
  第一週持續戒煙的比例為73%,第二週57.5%,到第六週為44.8%,與重新恢復吸煙的人比較,第1 ~ 2週仍在戒煙的人明顯有口腔潰瘍與感冒的症狀,包括喉嚨痛、咳嗽、失聰與打噴嚏等,在戒煙的第一個星期中,約1/3的人產生3種以上的症狀,但6週之後這些症狀都消退了。
  
  戒煙會增加口腔潰瘍的機率可能是因為吸煙的抗菌效果遭到破壞所致,而感冒症狀則可能因為戒煙後唾液中的免疫球蛋白減少所引起。
  
  這個研究的限制包括,每個人的感受程度不同、樣本數相對較小,因此作者希望未來能更進一步研究戒煙之後這些症狀改變的身心作用機轉,以找出解決的方法。

Smoking Cessation Linked to Co

By Laurie Barclay, MD
Medscape Medical News

Feb. 27, 2003 — A prospective study reported in the February issue of Tobacco Control is the first to document systematically that smoking cessation is significantly associated with an increased risk of cold symptoms and mouth ulcers. The investigators suggest that informing patients of these risks will increase the likelihood of successful cessation.

"Smokers need to be informed that they have an increased chance of experiencing an elevation in cold symptoms and mouth ulcers on stopping smoking," write Michael Ussher, from St. George's Hospital Medical School in London, U.K., and colleagues. "Being psychologically prepared for these effects is likely to mitigate their impact on the cessation attempt."

Dr. Ussher's group studied 174 smokers enrolled in a seven-week smoking cessation program combining behavioral support and nicotine patches. Almost two-thirds of subjects were women; average age was 43 years. All had been smoking for at least three years, and the average number of cigarettes smoked was one pack daily.

The proportion of subjects maintaining abstinence was 73% at one week, 57.5% at two weeks, and 44.8% at six weeks. Compared with those who had resumed smoking, those abstaining for one and two weeks were significantly more likely to report mouth ulcers and cold symptoms, including sore throat, coughing, deafness, and sneezing. During the first week of abstinence, about one-third of subjects developed three or more symptoms. After six weeks, all symptoms subsided.

Study limitations include use of self-reports and relatively small sample size. The authors recommend further research to investigate possible psychological and physiological mechanisms underlying reported changes in symptoms after quitting smoking.

"Having realistic expectations of the consequences of medical interventions increases the chances of positive outcomes," the authors write. "Increases in mouth ulcers following smoking cessation may be related to the loss of the antibacterial effect of smoking. Increases in cold symptoms could be explained by a reduction in salivary immunoglobulin A upon stopping smoking."

Tobacco Control. 2003;12:86-88

Reviewed by Gary D. Vogin, MD

    
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