Oleh Admin Kalbe Medical pada January 03, 2017 08:00

Respons Abstinens Awal dan Dampak Jangka Panjangnya pada Usaha Berhenti Merokok

Merokok adalah salah satu kebiasaan buruk yang sangat merugikan kesehatan karena berkaitan dengan banyak penyakit degeneratif seperti penyakit jantung koroner, penyakit paru obstruktif kronik, dan tromboangitis obliterans. Akan tetapi, banyak orang yang sulit berhenti merokok karena efek adiksi dari nikotin.

Ada beberapa faktor yang mempengaruhi apakah usaha smoking cessation akan berhasil atau tidak, misalnya: usia, pendidikan, pekerjaan, dan lainnya. Salah satu yang diduga berpengaruh terhadap keberhasilan pengobatan jangka panjang adalah respons abstinens awal saat pasien mendapatkan pengobatan. Untuk mengetahuinya maka dr. Piper dan tim dari USA melakukan sebuah penelitian yang diterbitkan di jurnal Addiction tahun 2016.


Pada penelitian kohort ini, peneliti mengevaluasi persepsi yang timbul pada hari pertama pasien berhenti merokok dan mendapatkan pengobatan, kemudian melakukan follow up selama 8 minggu dan 6 bulan untuk melihat keberhasilan pengobatannya. Hasilnya, dari total 1236 pasien yang ikut serta, gejala hari pertama pasien dikelompokkan menjadi 4 kelompok, yaitu: moderate withdrawal (64%), high craving-anhedonia (8%), affective withdrawal (13%), dan lapar (15%). Setelah dilakukan follow up, ternyata didapatkan bahwa kelompok yang mengalami high craving-anhedonia lebih berisiko untuk mengalami relaps yang lebih cepat dibandingkan dengan kelompok yang mengalami moderate withdrawal (p<0,01). Selain itu juga, kelompok affective withdrawal juga mengalami risiko relaps yang lebih tinggi dibandingkan dengan kelompok moderate withdrawal (p<0,01).


Kesimpulan:
Sebagian kecil pasien medikasi berhenti merokok mengalami gejala berat pada awal abstinens yang dikenal sebagai high craving-anhedonia dan affective withdrawal. Pasien yang mengalami gejala ini lebih rentan untuk relaps dan gagal pengobatan. Diperlukan perhatian khusus apabila pasien berhenti merokok mengalami gejala high craving-anhedonia dan affective withdrawal. (NNO)

Image : Ilustrasi
Referensi:
1.Nicotine addiction treatment & management: Approach considerations, counseling, nicotine replacement therapy [Internet]. 2016 Oct 28 [cited 2016 Dec 25]. Available from: http://emedicine.medscape.com/article/287555-treatment?pa=zg%2BBbE5Sh1CCj9WzjN1S7ReMYIYFhUGmayhK9BIzeih1pThq6ojTc0pKj7FQ%2BeU8uTRqQxidkpP%2FiIJ5YwNowV%2FDMAtBBAsM6eN9kpLn%2Fas%3D
2.Piper ME, Vasilenko SA, Cook JW, Lanza ST. What a difference a day makes: Differences in initial abstinence response during a smoking cessation attempt. Addict Abingdon Engl. 2016 Sep 15;

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