Varenicline helps smokers quit gradually

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A new study suggests the use of medication could help smokers quit the habit gradually, resulting in better smoking cessation rates, reports Medical News Today.

Current quit smoking guidelines from the US Department of Health and Human Services recommend that smokers give up the habit as quickly as possible by setting a quit date in the near future. However, the researchers of this latest study – including Dr Jon O Ebbert of the Mayo Clinic – note that only 8% of smokers say they are ready to quit within the next month. In addition, the team points to a telephone survey of more than 1,000 current daily cigarette smokers in the US, which revealed that around 44% would prefer to quit smoking through a steady reduction in the number of cigarettes smoked.

“Developing effective interventions to achieve tobacco abstinence through gradual reduction could engage more smokers in quitting,” say the researchers. As such, Ebbert and colleagues investigated the effectiveness of varenicline (brand name Chantix) – a medication used to treat nicotine addiction – in helping smokers reduce their cigarette use gradually, with the aim of making them quit for good.

For their study, the team recruited 1,510 cigarette smokers from over 10 countries who were unwilling or unable to stop smoking within the next month, but who were willing to try and quit smoking within the next 3 months. The participants were randomly assigned to receive either 1 mg of varenicline or a placebo twice daily for 24 weeks. They were followed-up for 1 year. At study baseline, the participants were given a target to reduce the number of cigarettes they smoked by at least 50% at 4 weeks and 75% at 8 weeks. At 12 weeks, they were told to make a quit attempt.

By week 4, the team found that 47.1% of participants who received varenicline had reduced the number of cigarettes smoked by at least 50%, compared with 31.1% of participants who received the placebo. At 8 weeks, 26.3% of those treated with varenicline reached the 75% cigarette reduction target, compared with 15.1% treated with the placebo. When it came to quitting smoking, the researchers found that the participants treated with varenicline had much higher abstinence rates. At weeks 15-24, 32.1% of participants who received varenicline had ongoing smoking abstinence, compared with only 6.9% of those who received the placebo.

At weeks 21-24, continuous smoking abstinence rates for participants who received varenicline stood at 37.8%, compared with 12.5% who received the placebo, while at weeks 21-52, abstinence rates were 27% for the varenicline group and 9.9% for the placebo group.

The team notes that 3.7% of participants treated with varenicline experienced serious adverse events, compared with 2.2% of those treated with the placebo. In particular, the drug was linked to increased rates of constipation and weight gain, though the researchers note that these effects are also known to be caused by smoking cessation.

Overall, the researchers say their findings suggest varenicline may be an effective treatment option for smokers who are unable or unwilling to stop smoking quickly like the current US clinical guidelines recommend. The team says there were some limitations to their study.

Full Medical News Today report
JAMA abstract

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