Safety of varenicline as an aid to smoking cessation in professional drivers and its impact on driving behaviors: An observational cohort study of taxi drivers in Beijing

Abstract

INTRODUCTION Varenicline is an effective smoking cessation medicine. However, the possible adverse neuropsychiatric events reported by Food and Drug Administration for varenicline may cause safety problems for professional drivers. We aimed to investigate its safety and impacts on driving behaviors among taxi drivers in Beijing, China. METHODS An observational cohort study was conducted in a smoking cessation clinic in Beijing, China, between September 2017 and April 2018. Smokers with varenicline for smoking cessation were included and categorized into taxi-driver smokers (n=103) and non-taxi-driver smokers (n=119). All participants received varenicline up to 12 weeks and five standardized counseling sessions. Treatmentrelated adverse events (AEs) were collected in all participants and their impacts on driving behaviors were assessed in taxi-driver smokers. Multiple logistic regression analysis was used to examine potential risk factors for vareniclinerelated somnolence/fatigue. RESULTS The incidence of most treatment-related AEs was similar between taxidriver smokers and non-taxi-driver smokers, but treatment-related somnolence/ fatigue was more frequently reported in taxi-driver smokers (18.4% vs 6.7%; p=0.008). Most taxi-driver smokers (87.4%) reported that treatment-related AEs did not affect their driving behaviors, and no traffic accident was reported during treatment. CONCLUSIONS Varenicline appears to be a well-tolerated smoking cessation aid for Beijing taxi drivers and has less impact on driving behaviors. However, taxidriver smokers were more likely to report somnolence/fatigue during varenicline treatment and physicians should pay more attention to this occupational population.

Identifying determinants of varenicline adherence using the Theoretical Domains framework: a rapid review

“…Most of the studies included in this review consisted of RCTs ( n = 38) [ 32 – 69 ], followed by cohort ( n = 17) [ 70 – 86 ], cross-sectional ( n = 3) [ 87 – 89 ], quasi-experimental ( n = 3) [ 90 – 92 ], and qualitative ( n = 1) [ 93 ] studies, and one study ( n = 1) [ 53 ] was a mediation analysis that examined an observational study and RCT. The majority of studies had a low to moderate risk of bias [27 studies were of low risk of bias [ 37 – 39 , 42 , 44 , 47 – 56 , 61 , 65 , 71 – 73 , 75 , 83 , 84 , 86 , 88 , 92 , 93 ]; 28 studies were of moderate risk [ 32 , 33 , 35 , 40 , 41 , 43 , 45 , 46 , 59 , 60 , 62 – 64 , 66 – 70 , 77 – 82 , 85 , 87 , 89 , 90 ]; and six studies were of high risk of bias [ 36 , 57 , 58 , 74 , 76 , 91 ]]. Studies were conducted in a multitude of countries across all continents except Antarctica.…”

“…A few studies investigated specific patient populations: cancer ( n = 3) [ 34 , 36 , 82 ]; chronic obstructive pulmonary disease ( n = 3) [ 61 , 75 , 78 ]; human immunodeficiency viruses ( n = 3) [ 54 , 58 , 66 ]; psychiatric conditions ( n = 2) [ 46 , 84 ]; and people undergoing substance use disorder treatment, including methadone treatment ( n = 2) [ 47 , 56 ]. There was a fairly even gender split among participants in the included studies, although 20 studies reported 30% or fewer female participants [ 71 , 72 , 38 , 39 , 77 – 79 , 46 , 48 , 80 , 81 , 89 , 54 , 84 , 55 , 58 , 92 , 65 , 66 , 86 ]. Table 1 provides a summary of the included studies.…”

Awareness and needs of smoking cessation services for female emotional laborers, parcel delivery workers, transportation workers, and construction workers in Korea

“…Additionally, varenicline, a smoking cessation aid, should be prescribed with caution for transportation workers because it can induce drowsiness and fatigue. Hence, smoking cessation services, as opposed to drugs, are more suitable for this group of workers [13]. While the percentage of older workers is growing rapidly, with workers aged ≥ 60 years accounting for 49.2% of all taxi drivers in 2015, their work schedules are not ideal for this age group, which has led to an increased rate of tra c accidents [14].…”

Awareness and Needs of Smoking Cessation Services for Female Emotional Laborers, Parcel Delivery Workers, Transportation Workers, and Construction Workers in South Korea

“…Transportation workers are at risk for lung cancer and are a difficult group to access to promote smoking cessation [ 12 ]. Additionally, varenicline, a smoking cessation aid, should be prescribed with caution for transportation workers because it can induce drowsiness and fatigue [ 13 ]. Smoking cessation services, as opposed to drugs, are more suitable for this group of workers [ 13 ].…”

“…Additionally, varenicline, a smoking cessation aid, should be prescribed with caution for transportation workers because it can induce drowsiness and fatigue [ 13 ]. Smoking cessation services, as opposed to drugs, are more suitable for this group of workers [ 13 ]. In South Korea, while the percentage of older adult transportation workers is growing rapidly (in 2015, workers aged ≥ 60 years accounted for 49.2% of all taxi drivers), their work schedules are not ideal for their age group, which has led to an increased rate of traffic accidents [ 14 ].…”