Latar belakang: Penggunaan tembakau menimbulkan ketergantungan nikotin sehingga proses berhenti merokok menjadi sulit dan membutuhkan bantuan khusus. Keterbatasan terapi berhenti merokok di Indonesia mendorong lahirnya terapi farmakologi alternatif. Hasil penelitian preklinik menunjukkan terdapat peluang efektivitas N-acetylcistein (NAC) terhadap berhenti merokok.Metode: Penelitian ini menggunakan uji acak plasebo terkontrol pada perokok yang dilakukan selama Januari-Desember 2018. Sebanyak 90 perokok mendapatkan perlakuan yang dibedakan menjadi dua kelompok yaitu NAC 2x1200 mg dan plasebo selama 4 minggu. Pengamatan dilakukan pada minggu ke 1,2,3 dan 4. Pada akhir perlakuan dilakukan penilaian abstinence rate (AR), nilai withdrawal dan craving.Hasil: Nilai AR pada kelompok NAC sebesar 37,7% sementara kelompok plasebo 6,7%. Pada variabel demografi yang bermakna terhadap abstinence adalah skor Fagestorm, motivasi dan nilai CO ekshalasi dasar dan percobaan berhenti merokok sebelumnya. Pada variabel akhir penelitian yaitu nilai CO ekshalasi akhir, jumlah rokok akhir, nilai withdrawal akhir dan nilai craving akhir bermakna secara statistik ( nilai p <0,001)Kesimpulan: Abstinence rate pada kelompok NAC lebih superior dibandingkan kelompok plasebo. Penelitian lebih lanjut perlu dilakukan dengan durasi pemberian lebih panjang dan pengamatan terhadap continues abstinance rate (CAR).

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Background: Tobacco cigarette smoking often resulted in nicotine dependence which caused difficulties in smoking cessation program which in turn requiring smokers to seek professional help. However, pharmacotherapy for smoking cessation was limited in Indonesia. Preclinical studies suggested n-acetylcysteine (NAC) might able to reduce withdrawal and craving symptoms for substance dependence particularly nicotine addiction among smokers.

Methods : This placebo controlled clinical trial was conducted between January to December 2018. This study randomly grouped 90 cigarette smokers into NAC-treated (NAC 1200 mg bid) and placebo group whose four weeks of treatment was observed. The study objective was to compare abstinence rate (AR), withdrawal, and craving symptoms using scoring system at the end of the study.

Results : The AR in NAC-treated group was 37.7% and in placebo group was 6.7%. Fagerstrom score of nicotine dependence, motivation, and base exhaled CO concentration were related to abstinence. Decrease of daily cigarette consumption and exhaled CO concentration, and changes in withdrawal and craving score, were observed among the smokers by the end of the study.

Conclusion : This preliminary study suggested feasibility and efficacy of NAC for smoking cessation. Follow-up study of NAC on AR should be carried out.