ABSTRACT Rationale: Nicotine nasal spray (NNS) may be better for relieving acute cigarette cravings than other nicotine replacement and it may help smokers with schizophrenia because of its rapid onset of action. Objectives: We tested whether NNS was more effective than a nicotine patch (NP; 21 mg) in reducing cue-induced craving during a 3-day abstinence. Methods: Twenty-five smokers with schizophrenia or schizoaffective disorder (SA) were randomized to open-label NNS or NP treatment after baseline measures of craving were assessed. NNS users were instructed to dose at a minimum of 1/hour and up to a maximum of 40/day. Averages from a 4-item visual analogue scale (need, urge, want to smoke, crave a cigarette) measured craving. Results: Five subjects who smoked (4 NP, 1 NNS) were excluded, leaving 21 (11 NP, 10 NNS) for analyses. No differences were detected between groups on baseline craving. On day 3, NNS users reported significantly less craving in response to smoking cues compared to NP users (mean craving scores: NNS, 7.0; NP, 20.3; p = .014). A repeated measure ANCOVA demonstrated significantly reduced craving in the NNS group compared to the NP group from baseline to day 3 (F = 5.09; p = .037). NNS users took an average of 20 doses/day, and NNS was rated as being as easy to use as NP. Conclusions: The potential utility of NNS in smokers with schizophrenia supports the need for placebo-controlled studies.

中文翻译：

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与尼古丁贴剂相比，使用尼古丁鼻喷雾剂对精神分裂症吸烟者渴望的开放标签研究

摘要理由：尼古丁鼻喷雾剂 (NNS) 可能比其他尼古丁替代品更能缓解急性吸烟的渴望，并且由于其起效迅速，因此可能有助于精神分裂症的吸烟者。目标：我们测试了 NNS 是否比尼古丁贴剂（NP；21 毫克）在减少 3 天禁欲期间减少提示诱发的渴望方面更有效。方法：25 名患有精神分裂症或分裂情感性障碍 (SA) 的吸烟者在评估基线渴望测量值后被随机分配接受开放标签 NNS 或 NP 治疗。NNS 用户被指示以最少 1 次/小时和最多 40 次/天的剂量给药。来自 4 项视觉模拟量表（需要、冲动、想要吸烟、渴望香烟）的平均值测量了渴望。结果：排除了 5 名吸烟的受试者（4 名 NP，1 名 NNS），剩下 21 名（11 名 NP，10 名 NNS）进行分析。在基线渴望方面，各组之间未检测到差异。在第 3 天，与 NP 用户相比，NNS 用户报告对吸烟线索的渴望明显减少（平均渴望分数：NNS，7.0；NP，20.3；p = .014）。重复测量 ANCOVA 表明，与 NP 组相比，从基线到第 3 天，NNS 组的渴望显着降低（F = 5.09；p = .037）。NNS 用户平均每天服用 20 剂，NNS 被评为与 NP 一样易于使用。结论：NNS 对精神分裂症吸烟者的潜在效用支持安慰剂对照研究的必要性。重复测量 ANCOVA 表明，与 NP 组相比，从基线到第 3 天，NNS 组的渴望显着降低（F = 5.09；p = .037）。NNS 用户平均每天服用 20 剂，NNS 被评为与 NP 一样易于使用。结论：NNS 对精神分裂症吸烟者的潜在效用支持安慰剂对照研究的必要性。重复测量 ANCOVA 表明，与 NP 组相比，从基线到第 3 天，NNS 组的渴望显着降低（F = 5.09；p = .037）。NNS 用户平均每天服用 20 剂，NNS 被评为与 NP 一样易于使用。结论：NNS 对精神分裂症吸烟者的潜在效用支持安慰剂对照研究的必要性。