簡易檢索 / 詳目顯示

研究生: 謝維哲
Hsieh, Wei-Che
論文名稱: 短暫戒菸時進行單次運動對吸菸渴望、戒斷症狀與皮質醇濃度之影響
Effects of a single exercise session on smoking craving, withdrawal symptoms, and cortisol concentrations during brief smoking abstinence
指導教授: 何仁育
Ho, Jen-Yu
口試委員: 林信甫
Lin, Hsin-Fu
陳勇志
Chen, Yung-Chih
何仁育
Ho, Jen-Yu
口試日期: 2022/11/30
學位類別: 碩士
Master
系所名稱: 運動競技學系
Department of Athletic Performance
論文出版年: 2022
畢業學年度: 111
語文別: 中文
論文頁數: 51
中文關鍵詞: 尼古丁成癮尼古丁戒斷症狀運動與戒菸
英文關鍵詞: nicotine addiction, nicotine withdrawal symptoms, exercise, smoking cessation
研究方法: 調查研究
DOI URL: http://doi.org/10.6345/NTNU202205654
論文種類: 學術論文
相關次數: 點閱:65下載:0
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 目的: 探討短暫戒菸期間進行單次中等強度腳踏車運動對吸菸渴望與戒斷症狀的影響,並釐清戒菸期間運動後皮質醇濃度的變化,以及與兩指標間的相關性。方法: 本研究招募12名吸菸男性 (菸齡3年以上、無規律運動習慣且尼古丁成癮分數達4分以上),在進行24小時短暫戒菸後,依照尼古丁成癮分數進行配對分組,分配至運動組 (30分鐘強度為RPE11-13之腳踏車運動) 與控制組 (30分鐘休息),並在短暫戒菸前、戒菸後/介入前、介入後5分鐘進行血液採集 (分析皮質醇濃度),並填寫吸菸渴望與戒斷症狀量表,以混和設計二因子變異數分析及皮爾森積差相關進行統計分析。結果: 戒菸24小時後,所有受試者的戒斷症狀會顯著增加,而吸菸渴望雖也有增加,但未達顯著差異。本研究發現僅運動組的吸菸渴望在介入後5分鐘 (1.33±1.21分) 顯著降低於戒菸後/介入前(2.83±1.60分),戒斷症狀也同樣僅在運動介入後5分鐘 (9.67±1.86分) 顯著低於戒菸後/介入前 (15.17±6.65分)。皮質醇濃度在不同介入與評估時間上,皆無顯著差異 (p=.995)。此外,皮質醇濃度的變化與吸菸渴望的變化、以及戒斷症狀的變化上並無顯著相關。結論: 短暫戒菸24小時後,戒斷症狀會顯著增加,但單次運動能幫助降低吸菸渴望與戒斷症狀;此外,皮質醇可能不是戒菸時運動能幫助戒菸的生理因素。

    Purpose: To investigate acute effects of moderate-intensity cycling exercise on smoking craving and withdrawal symptoms following brief smoking cessation, and to clarify the response of cortisol to exercise and its correlation with carving and withdrawal symptoms. Methods: Twelve smoking males (smoking for more than three years, not trained, and nicotine dependence test score is 4 or more points) were recruited, matched in pair, and then assigned to Exercise group (30 minutes of cycling exercise at moderate intensity, RPE11-13) or Control group (30 minutes of rest) in this study. The smoking assessment (craving and withdrawal intensity) and blood sampling (for cortisol analysis) were obtained at baseline (before smoking cessation), after 24-hour smoking cessation/before the intervention, and 5 minutes after the intervention. A mixed two-way ANOVA (intervention x time) and the Bonferroni post hoc were used to analyze the data. A significant level is set at α = .05. Results: After 24 hours of quitting, while the withdrawal symptoms of all subjects increased significantly, the craving for smoking also increased, but not significantly. After intervention, the smoking craving significantly decreased (2.83±1.60 to 1.33±1.21 point) only in Exercise group. Similarly, the withdrawal symptoms also significantly decreased (15.17±6.65 to 9.67±1.86 points) after intervention only in Exercise group. However, there were no significant differences in cortisol concentrations at any time points or between groups. Furthermore, the changes in cortisol concentrations were not significantly correlated with changes in smoking cravings or withdrawal symptoms. Conclusions: A single bout of exercise can reduce smoking cravings and withdrawal symptoms following a 24-hour smoking cessation. However, cortisol may not play a role in regulation of exercise on smoking craving and withdrawal symptoms during brief smoking abstinence.

    目 次 中文摘要 i 英文摘要ii 謝誌 iii 目次 iv 表次 vii 圖次 vii 第壹章 緒論 1 第一節 前言 1 第二節 問題背景 3 第三節 研究目的 5 第四節 研究假設 5 第五節 研究範圍與限制 5 第六節 研究重要性 6 第七節 名詞操作性定義 6 第貳章 文獻探討 8 第一節 短暫戒菸時吸菸渴望與戒斷症狀探討 8 第二節 短暫戒菸時運動介入對吸菸渴望與戒斷症狀影響之探討 9 第三節 短暫戒菸時單次運動後皮質醇變化之探討 10 第四節 文獻總結 12 第參章 研究方法 14 第一節 研究受試者 14 第二節 實驗設計與流程 14 第三節 實驗方法與步驟 16 第四節 實驗控制 19 第五節 資料處理與統計方法 19 第肆章 結果 20 第一節 受試者基本資料 20 第二節 戒菸期間不同介入下戒斷症狀、吸菸渴望皮質醇的反應 22 第三節 皮質醇濃度變化與戒斷症狀程度及吸菸渴望程度變化之相關性 24 第四節 不同介入後回復吸菸之概況 25 第伍章 討論 26 第一節 短暫戒菸時進行單次運動對戒斷症狀與吸菸渴望之影響 26 第二節 短暫戒菸時進行單次運動對皮質醇之影響 29 第三節 皮質醇濃度變化與戒斷症狀及吸菸渴望之相關性探討 31 第四節 結論與建議 32 參考文獻 33   附錄 44 附錄一 健康狀況調查表 44 附錄二 尼古丁成癮量表 45 附錄三 受試者同意書 46 附錄四 受試者須知 47 附錄五 戒斷症狀評估量表(MPSS) 48 附錄六 吸菸渴望評估量表49 附錄七 實驗記錄表格 50 附錄八 回復吸菸情況自主追蹤表 51   表次 表1 受試者基本資料 20 表2 運動組RPE與心率資料 21 表3 戒斷症狀程度變化 22 表4 吸菸渴望程度變化 23 表5 皮質醇濃度變化 24 表6 皮質醇濃度變化與戒斷症狀變化程度之相關性 24 表7 皮質醇濃度變化吸菸渴望變化程度之相關性 24 表8 介入後回復吸菸概況 25 圖次 圖1 實驗設計流程圖 14

    吳映萱、黃柏誠 (2019)。成人戒菸藥物治療。家庭醫學與基層醫療,34(10),292-297。
    Abrantes, A. M., Bloom, E. L., Strong, D. R., Riebe, D., Marcus, B. H., Desaulniers, J., . . . Brown, R. A. (2014). A Preliminary Randomized Controlled Trial of a Behavioral Exercise Intervention for Smoking Cessation. Nicotine & Tobacco Research, 16(8), 1094-1103. doi: 10.1093/ntr/ntu036
    Adam, E. K., Doane, L. D., Zinbarg, R. E., Mineka, S., Craske, M. G., & Griffith, J. W. (2010). Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence. Psychoneuroendocrinology, 35(6), 921-931. doi: 10.1016/j.psyneuen.2009.12.007
    al'Absi, M., Lemieux, A., Westra, R., & Allen, S. (2017). Early life adversity influences stress response association with smoking relapse. Psychopharmacology, 234(22), 3375-3384. doi: 10.1007/s00213-017-4724-4
    al’Absi, M., Hatsukami, D., Davis, G. L., & Wittmers, L. E. (2004). Prospective examination of effects of smoking abstinence on cortisol and withdrawal symptoms as predictors of early smoking relapse. Drug and Alcohol Dependence, 73(3), 267-278. doi: https://doi.org/10.1016/j.drugalcdep.2003.10.014
    Ambrose, J. A., & Barua, R. S. (2004). The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol, 43(10), 1731-1737. doi: 10.1016/j.jacc.2003.12.047
    Belmaker, R. H., & Agam, G. (2008). Major depressive disorder. New England Journal of Medicine, 358(1), 55-68. doi: 10.1056/NEJMra073096
    Bradley, B. P., Garner, M., Hudson, L., & Mogg, K. (2007). Influence of negative affect on selective attention to smoking-related cues and urge to smoke in cigarette smokers. Behav Pharmacol, 18(4), 255-263. doi: 10.1097/FBP.0b013e328173969b
    Cohen, L. M., Al'Absi, M., & Collins Jr, F. L. (2004). Salivary cortisol concentrations are associated with acute nicotine withdrawal. Addictive Behaviors, 29(8), 1673-1678. doi: 10.1016/j.addbeh.2004.02.059
    Conklin, C. A., & Perkins, K. A. (2005). Subjective and reinforcing effects of smoking during negative mood induction. J Abnorm Psychol, 114(1), 153-164. doi: 10.1037/0021-843x.114.1.153
    Daniel, J., Cropley, M., Ussher, M., & West, R. (2004). Acute effects of a short bout of moderate versus light intensity exercise versus inactivity on tobacco withdrawal symptoms in sedentary smokers. Psychopharmacology (Berl), 174(3), 320-326. doi: 10.1007/s00213-003-1762-x
    Daniel, J., Cropley, M., Ussher, M., & West, R. (2004). Acute effects of a short bout of moderate versus light intensity exercise versus inactivity on tobacco withdrawal symptoms in sedentary smokers. Psychopharmacology, 174(3), 320-326. doi: 10.1007/s00213-003-1762-x
    Daniel, J. Z., Cropley, M., & Fife-Schaw, C. (2006). The effect of exercise in reducing desire to smoke and cigarette withdrawal symptoms is not caused by distraction. Addiction, 101(8), 1187-1192. doi: 10.1111/j.1360-0443.2006.01457.x
    Daniel, J. Z., Cropley, M., & Fife-Schaw, C. (2007). Acute exercise effects on smoking withdrawal symptoms and desire to smoke are not related to expectation. Psychopharmacology (Berl), 195(1), 125-129. doi: 10.1007/s00213-007-0889-6
    De Jesus, S., & Prapavessis, H. (2018). Affect and cortisol mechanisms through which acute exercise attenuates cigarette cravings during a temporary quit attempt. Addictive Behaviors, 80, 82-88. doi: https://doi.org/10.1016/j.addbeh.2018.01.007
    De Jesus, S., & Prapavessis, H. (2018). Smoking behaviour and sensations during the pre-quit period of an exercise-aided smoking cessation intervention. Addict Behav, 81, 143-149. doi: 10.1016/j.addbeh.2018.01.035
    Ekkekakis, P., Hall, E. E., & Petruzzello, S. J. (2005). Variation and homogeneity in affective responses to physical activity of varying intensities: An alternative perspective on dose-response based on evolutionary considerations. Journal of Sports Sciences, 23(5), 477-500. doi: 10.1080/02640410400021492
    Everson, E. S., Daley, A. J., & Ussher, M. (2006). Does exercise have an acute effect on desire to smoke, mood and withdrawal symptoms in abstaining adolescent smokers? Addict Behav, 31(9), 1547-1558. doi: 10.1016/j.addbeh.2005.11.007
    Everson, E. S., Daley, A. J., & Ussher, M. (2008). The effects of moderate and vigorous exercise on desire to smoke, withdrawal symptoms and mood in abstaining young adult smokers. Mental Health and Physical Activity, 1(1), 26-31. doi: https://doi.org/10.1016/j.mhpa.2008.06.001
    Fong, A. J., De Jesus, S., Bray, S. R., & Prapavessis, H. (2014). Effect of exercise on cigarette cravings and ad libitum smoking following concurrent stressors. Addictive Behaviors, 39(10), 1516-1521. doi: https://doi.org/10.1016/j.addbeh.2014.05.027
    Georgakouli, K., Manthou, E., Georgoulias, P., Ziaka, A., Deli, C. K., Draganidis, D., . . . Jamurtas, A. Z. (2021). HPA axis responses to acute exercise differ in smokers and non-smokers. Physiology & Behavior, 229, 113258. doi: https://doi.org/10.1016/j.physbeh.2020.113258
    Gilbert, D. G., Meliska, C. J., Williams, C. L., & Jensen, R. A. (1992). Subjective correlates of cigarette-smoking-induced elevations of peripheral beta-endorphin and cortisol. Psychopharmacology, 106(2), 275-281. doi: 10.1007/BF02801984
    Haasova, M., Warren, F. C., Ussher, M., Janse Van Rensburg, K., Faulkner, G., Cropley, M., . . . Taylor, A. H. (2014). The acute effects of physical activity on cigarette cravings: Exploration of potential moderators, mediators and physical activity attributes using individual participant data (IPD) meta-analyses. Psychopharmacology, 231(7), 1267-1275. doi: 10.1007/s00213-014-3450-4
    Hall, E. E., Ekkekakis, P., & Petruzzello, S. J. (2002). The affective beneficence of vigorous exercise revisited. British Journal of Health Psychology, 7(1), 47-66. doi: 10.1348/135910702169358
    Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict, 86(9), 1119-1127. doi: 10.1111/j.1360-0443.1991.tb01879.x
    Herbert, J., Goodyer, I. M., Grossman, A. B., Hastings, M. H., de Kloet, E. R., Lightman, S. L., . . . Seckl, J. R. (2006). Do corticosteroids damage the brain? Journal of Neuroendocrinology, 18(6), 393-411. doi: 10.1111/j.1365-2826.2006.01429.x
    Herman, A. I., DeVito, E. E., Jensen, K. P., & Sofuoglu, M. (2014). Pharmacogenetics of nicotine addiction: role of dopamine. Pharmacogenomics, 15(2), 221-234. doi: 10.2217/pgs.13.246
    Hill, E. E., Zack, E., Battaglini, C., Viru, M., Viru, A., & Hackney, A. C. (2008). Exercise and circulating cortisol levels: the intensity threshold effect. J Endocrinol Invest, 31(7), 587-591. doi: 10.1007/bf03345606
    Jacks, D. E., Sowash, J., Anning, J., McGloughlin, T., & Andres, F. (2002). Effect of exercise at three exercise intensities on salivary cortisol. J Strength Cond Res, 16(2), 286-289.
    Jha, P. (2009). Avoidable global cancer deaths and total deaths from smoking. Nature Reviews Cancer, 9(9), 655-664. doi: 10.1038/nrc2703
    Jha, P., & Peto, R. (2014). Global Effects of Smoking, of Quitting, and of Taxing Tobacco. New England Journal of Medicine, 370(1), 60-68. doi: 10.1056/NEJMra1308383
    Karelitz, J. L., McClure, E. A., Wolford-Clevenger, C., Pacek, L. R., & Cropsey, K. L. (2021). Cessation classification likelihood increases with higher expired-air carbon monoxide cutoffs: a meta-analysis. Drug Alcohol Depend, 221, 108570. doi: 10.1016/j.drugalcdep.2021.108570
    Kassel, J. D. (2000). Smoking and stress: correlation, causation, and context. Am Psychol, 55(10), 1155-1156. doi: 10.1037//0003-066x.55.10.1155
    Klinsophon, T., Thaveeratitham, P., Sitthipornvorakul, E., & Janwantanakul, P. (2017). Effect of exercise type on smoking cessation: a meta-analysis of randomized controlled trials. BMC Res Notes, 10(1), 442. doi: 10.1186/s13104-017-2762-y
    Marcus, B. H., Lewis, B. A., Hogan, J., King, T. K., Albrecht, A. E., Bock, B., . . . Abrams, D. B. (2005). The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: a randomized controlled trial. Nicotine Tob Res, 7(6), 871-880. doi: 10.1080/14622200500266056
    Matheny, K. B., & Weatherman, K. E. (1998). Predictors of smoking cessation and maintenance. J Clin Psychol, 54(2), 223-235. doi: 10.1002/(sici)1097-4679(199802)54:2<223::aid-jclp12>3.0.co;2-l
    Meeusen, R., Piacentini, M. F., Kempenaers, F., Busschaert, B., De Schutter, G., Buyse, L., & De Meirleir, K. (2001). Brain neurotransmitter levels during exercise. Deutsche Zeitschrift fur Sportmedizin, 52(12), 361-368.
    Miller, G. E., Chen, E., & Zhou, E. S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychological Bulletin, 133(1), 25-45. doi: 10.1037/0033-2909.133.1.25
    Minami, J., Ishimitsu, T., & Matsuoka, H. (1999). Effects of smoking cessation on blood pressure and heart rate variability in habitual smokers. Hypertension, 33(1 Pt 2), 586-590. doi: 10.1161/01.hyp.33.1.586
    Mitrouska, I., Bouloukaki, I., & Siafakas, N. M. (2007). Pharmacological approaches to smoking cessation. Pulm Pharmacol Ther, 20(3), 220-232. doi: 10.1016/j.pupt.2005.10.012
    Nides, M. (2008). Update on pharmacologic options for smoking cessation treatment. Am J Med, 121(4 Suppl 1), S20-31. doi: 10.1016/j.amjmed.2008.01.016
    Parrott, A. C. (1999). Does cigarette smoking cause stress? Am Psychol, 54(10), 817-820. doi: 10.1037//0003-066x.54.10.817
    Patten, C. A., Vickers, K. S., Martin, J. E., & Williams, C. D. (2003). Exercise interventions for smokers with a history of alcoholism: exercise adherence rates and effect of depression on adherence. Addict Behav, 28(4), 657-667. doi: 10.1016/s0306-4603(01)00280-5
    Picciotto, M. R., & Kenny, P. J. (2021). Mechanisms of Nicotine Addiction. Cold Spring Harb Perspect Med, 11(5). doi: 10.1101/cshperspect.a039610
    Pomerleau, C. S., Marks, J. L., & Pomerleau, O. F. (2000). Who gets what symptom? Effects of psychiatric cofactors and nicotine dependence on patterns of smoking withdrawal symptomatology. Nicotine & Tobacco Research, 2(3), 275-280. doi: 10.1080/14622200050147547
    Pomerleau, O. F., & Pomerleau, C. S. (1991). Research on stress and smoking: progress and problems. Br J Addict, 86(5), 599-603. doi: 10.1111/j.1360-0443.1991.tb01815.x
    Roberts, V., Gant, N., Sollers, J. J., 3rd, Bullen, C., Jiang, Y., & Maddison, R. (2015). Effects of exercise on the desire to smoke and physiological responses to temporary smoking abstinence: a crossover trial. Psychopharmacology (Berl), 232(6), 1071-1081. doi: 10.1007/s00213-014-3742-8
    Roberts, V., Gant, N., Sollers, J. J., Bullen, C., Jiang, Y., & Maddison, R. (2015). Effects of exercise on the desire to smoke and physiological responses to temporary smoking abstinence: a crossover trial. Psychopharmacology, 232(6), 1071-1081. doi: 10.1007/s00213-014-3742-8
    Roberts, V., Maddison, R., Simpson, C., Bullen, C., & Prapavessis, H. (2012). The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: systematic review update and meta-analysis. Psychopharmacology (Berl), 222(1), 1-15. doi: 10.1007/s00213-012-2731-z
    Rose, J. E., Behm, F. M., Drgon, T., Johnson, C., & Uhl, G. R. (2010). Personalized smoking cessation: interactions between nicotine dose, dependence and quit-success genotype score. Mol Med, 16(7-8), 247-253. doi: 10.2119/molmed.2009.00159
    Ross, K. M., Murphy, M. L. M., Adam, E. K., Chen, E., & Miller, G. E. (2014). How stable are diurnal cortisol activity indices in healthy individuals? Evidence from three multi-wave studies. Psychoneuroendocrinology, 39, 184-193. doi: https://doi.org/10.1016/j.psyneuen.2013.09.016
    Samet, J. M. (2013). Tobacco smoking: the leading cause of preventable disease worldwide. Thorac Surg Clin, 23(2), 103-112. doi: 10.1016/j.thorsurg.2013.01.009
    Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000a). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocrine Reviews, 21(1), 55-89. doi: 10.1210/er.21.1.55
    Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000b). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocr Rev, 21(1), 55-89. doi: 10.1210/edrv.21.1.0389
    Sayette, M. A., Shiffman, S., Tiffany, S. T., Niaura, R. S., Martin, C. S., & Shadel, W. G. (2000). The measurement of drug craving. Addiction, 95 Suppl 2(Suppl 2), S189-210. doi: 10.1080/09652140050111762
    Scerbo, F., Faulkner, G., Taylor, A., & Thomas, S. (2010). Effects of exercise on cravings to smoke: The role of exercise intensity and cortisol. Journal of Sports Sciences, 28(1), 11-19. doi: 10.1080/02640410903390089
    Shiffman, S., Gnys, M., Richards, T. J., Paty, J. A., Hickcox, M., & Kassel, J. D. (1996). Temptations to smoke after quitting: a comparison of lapsers and maintainers. Health Psychol, 15(6), 455-461. doi: 10.1037//0278-6133.15.6.455
    Steptoe, A., & Ussher, M. (2006). Smoking, cortisol and nicotine. International Journal of Psychophysiology, 59(3), 228-235. doi: https://doi.org/10.1016/j.ijpsycho.2005.10.011
    Steptoe, A., & Ussher, M. (2006). Smoking, cortisol and nicotine. Int J Psychophysiol, 59(3), 228-235. doi: 10.1016/j.ijpsycho.2005.10.011
    Taylor, A. H., Ussher, M. H., & Faulkner, G. (2007a). The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction, 102(4), 534-543. doi: 10.1111/j.1360-0443.2006.01739.x
    Taylor, A. H., Ussher, M. H., & Faulkner, G. (2007b). The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: A systematic review. Addiction, 102(4), 534-543. doi: 10.1111/j.1360-0443.2006.01739.x
    Tiffany, S. T., & Drobes, D. J. (1991). The development and initial validation of a questionnaire on smoking urges. British Journal of Addiction, 86(11), 1467-1476. doi: https://doi.org/10.1111/j.1360-0443.1991.tb01732.x
    Ussher, M., Cropley, M., Playle, S., Mohidin, R., & West, R. (2009). Effect of isometric exercise and body scanning on cigarette cravings and withdrawal symptoms. Addiction, 104(7), 1251-1257. doi: 10.1111/j.1360-0443.2009.02605.x
    Ussher, M., Nunziata, P., Cropley, M., & West, R. (2001). Effect of a short bout of exercise on tobacco withdrawal symptoms and desire to smoke. Psychopharmacology (Berl), 158(1), 66-72. doi: 10.1007/s002130100846
    Ussher, M. H., Faulkner, G. E. J., Angus, K., Hartmann-Boyce, J., & Taylor, A. H. (2019). Exercise interventions for smoking cessation. Cochrane Database Syst Rev, 2019(10). doi: 10.1002/14651858.CD002295.pub6
    Ussher, M. H., Taylor, A. H., & Faulkner, G. E. (2014). Exercise interventions for smoking cessation. Cochrane Database Syst Rev(8), Cd002295. doi: 10.1002/14651858.CD002295.pub5
    Vale, R., Rosa, G., Nodari-Junior, R., & Dantas, E. (2012). Cortisol and physical exercise.
    West, R., & Hajek, P. (2004). Evaluation of the mood and physical symptoms scale (MPSS) to assess cigarette withdrawal. Psychopharmacology (Berl), 177(1-2), 195-199. doi: 10.1007/s00213-004-1923-6
    West, R. J., & Russell, M. A. (1985). Pre-abstinence smoke intake and smoking motivation as predictors of severity of cigarette withdrawal symptoms. Psychopharmacology (Berl), 87(3), 334-336. doi: 10.1007/bf00432717
    World Health, O. (2021). WHO report on the global tobacco epidemic, 2021: addressing new and emerging products: executive summary. Geneva: World Health Organization.
    Zhou, X., Nonnemaker, J., Sherrill, B., Gilsenan, A. W., Coste, F., & West, R. (2009). Attempts to quit smoking and relapse: factors associated with success or failure from the ATTEMPT cohort study. Addict Behav, 34(4), 365-373. doi: 10.1016/j.addbeh.2008.11.013

    無法下載圖示 電子全文延後公開
    2025/11/18
    QR CODE