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Smoking cessation drug ‘no better than patches’

Taking a smoking cessation drug was no better than using nicotine patches at helping people to maintain long-term abstinence from smoking, a study has found.

Researchers from the University of Wisconsin randomly assigned smokers to trial one of three therapies – varenicline, nicotine patches or a combination of patches and lozenges – for 12 weeks, and found that there was no difference in their ability to prevent smokers go back to old habits six or 12 months later.

Abstinence rates were around 25% in all three treatment groups at six months and 20% at 12 months.

In addition, varenicline was no better than a combination of patches and lozenges at alleviating initial craving symptoms, yet was associated with more adverse effects. Varenicline users reported more cases of insomnia, nausea and tiredness than participants using the patches alone or the combination of patches and lozenges.

The study, published in JAMA, comes after a Cochrane review in 2013 found that varenicline and a combination of patches and lozenges were effective as each other. However, the latest study suggests the same results can be found by simply using a nicotine patch.

The researchers said that the results raise questions about using intense pharmacotherapy for smoking cessation, given the lack of evidence that it is superior to using patches alone.

They concluded: ‘Among adults motivated to quit smoking, 12 weeks of open-label treatment with nicotine patch, varenicline, or [combination nicotine replacement therapy] produced no significant differences in biochemically confirmed rates of smoking abstinence at 26 or 52 weeks.

‘The results raise questions about the current relative effectiveness of intense smoking cessation pharmacotherapies.’

However, they pointed out that the average individual in the study smoked 17 cigarettes a day, meaning that the results may not apply to very heavy smokers.

 

 

 

 

Readers' comments (4)

  • Vinci Ho

    Varenicline is always my second choice to nicotine patches unless there is contact dermatitis secondary to the patch.
    Lesson from Zyban(Bupropion) is still ringing....

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  • Yet another spurious study from another part of the world. Please could we stop this publication bias?
    Next thing you know we will be convincing ourselves that eConsult is the way forward!!

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  • The research is cr@p, like most research there will be a paper saying the exact opposite soon, or did previously.

    1st thing is patient needs to genuinely want to stop or no matter what the method likely to fail, and ideally a zero tolerance approach, as 1 fag inevitably will lead to others.

    Swapping 1 nicotine addiction with another ie patches or even vaping etc is still an addiction to nicotine, while Champix actually makes you stop wanting a cigarette physically.

    Clear practical day to day advantage seen in real life towards Champix - but only when they themselves want to stop.

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  • I had understood previously that varenicline did have a better success rate at 3-4 months but was the same by 12 months suggesting more had restarted.

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