Medication therapy can increase long-term success for smokers who want to cut back first, study finds

A study of more than 1,500 cigarette smokers who were not ready to quit smoking but were willing to cut back on cigarette consumption and combine their approach with varenicline (Chantix, Pfizer) increased their long-term success of quitting smoking, according to study published in the February issue of the Journal of the American Medical Association.

Jon O. Ebbert, MD, MSc, professor of medicine, Mayo Clinic, and colleagues, reported the effects of the prescription medication varenicline for increasing smoking abstinence rates among smokers who wanted to reduce the number of cigarettes they smoked before trying to quit completely.

DR EBBERTDr Ebbert and colleagues enrolled smokers who had no intention of quitting in the next month but who were willing to reduce the number of cigarettes they smoked while working toward a quit attempt in the next 3 months, and randomly assigned them to 6 months of varenicline or placebo along with behavioral strategies for smoking reduction. Their continuous smoking abstinence rates were evaluated at 6 and 12 months.

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In the a multinational study, researchers found that 760 participants receiving varenicline were greater than 4 times more likely to quit than the 750 participants receiving placebo at 6 months (32.1% vs. 6.9%) and more than 2 times more likely to quit than participants receiving a placebo at 12 months (27.0% vs. 9.9%).

“Among smokers who were not willing or able to quit in the next 30 days but willing to reduce their smoking rate and make a quit attempt by 3 months, varenicline significantly increased long-term smoking cessation rates compared to placebo,” said Dr Ebbert, who also is associate director for research in the Mayo Clinic Nicotine Dependence Center. “The results tell us that varenicline works to help people quit smoking completely long-term through a gradual reduction in the number of cigarettes they smoke.”

This study is important because this opens the door to treatment for approximately 14 million smokers who have no intention of quitting in the next 30 days but are willing to reduce their smoking rate while working toward a quit attempt, according to the authors.

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“In the past, these smokers may have not received medication therapy,” Dr Ebbert said.

Varenicline costs about $250 per month.

“Not all insurance companies require that a quit date be set before covering medication,” he said. “This data would suggest that among patients who want to work toward a quit date in 3 months through gradual smoking reduction, varenicline will increase long-term smoking cessation compared to placebo.”

This research was funded by Pfizer.

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