Quitting smoking before and after varenicline: a population study based on two representative samples of US smokers

Abstract

Background Varenicline is known to have greater efficacy than other pharmacotherapy for treating nicotine dependence and has gained popularity since its introduction in 2006. This study examines if adding varenicline to existing pharmacotherapies increased the population cessation rate. Methods Data are from two cross-sectional U.S. Current Population Surveys—Tobacco Use Supplements (2003 and 2010–2011). Smokers and recent quitters 18 or older (N=34,869 in 2003, N=27,751 in 2010–2011) were asked if they had used varenicline, bupropion or nicotine replacement therapies (NRT) in their most recent quit attempt. The annual cessation rate, the percent of smokers who were quit for ≥ 3 months, was compared between surveys. Results Varenicline use increased from 0% in 2003 to 10.9% in 2010–2011, while use of bupropion decreased from 9.1% to 3.5%, and NRT from 24.5% to 22.4%. Use of any pharmacotherapy increased 2.4 percentage points. Varenicline users stayed on cessation aids longer and were less likely to relapse than users of other pharmacotherapies in the first three months of a quit attempt, after which the difference was no longer significant. The change in annual cessation rate was negligible, from 4.5% in 2003 to 4.7% in 2010–2011 (P=0.36). Conclusion Addition of varenicline to the list of approved cessation aids has mainly led to displacement of other therapies. As a result, there was no meaningful change in population cessation rate despite a remarkable increase in varenicline use. The population impact of a new therapy is a function of more than efficacy or reach of the therapy.

Effect of telling patients their “spirometric-lung-age” on smoking cessation in Japanese smokers

“…Kotz et al described results from their prospective study in which varenicline users had a 3.8 times higher quit rate than subjects who chose the nicotine patch (25). In addition, the relapse rate after abstinence from smoking was demonstrably smaller in varenicline users than nicotine patch users (26). Since this information is widely distributed, this knowledge about pharmacotherapy seems to be the reason why more participants chose varenicline than a nicotine patch in the present study.…”

Long-term e-cigarette use and smoking cessation: a longitudinal study with US population

“…Even with the introduction of varenicline, a highly effective pharmacotherapy, the rate of using FDA-approved pharmacotherapies has hovered around 30% (similar to the 28% found in this study). The introduction of varenicline mainly displaced other therapies 35. In contrast, e-cigarettes do not appear to have simply displaced other therapies.…”

“…The introduction of varenicline mainly displaced other therapies. 35 In contrast, e-cigarettes do not appear to have simply displaced other therapies. Instead, they have contributed to a 50% increase in the rate of smokers using cessation aids ( provided one classifies e-cigarettes as a cessation aid).…”

Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation at 26 Weeks

“…Other meta-analyses, 3,4 and large individual clinical trials 5–9 also support the superiority of varenicline and C-NRT relative to monotherapies. While these two pharmacotherapies are frequently used in the clinical treatment of smokers; 10 they have never been directly contrasted in a randomized clinical trial (RCT).…”