Background: The use of varenicline tartrate alleviates postquit withdrawal discomfort, but it also seems to reduce the “reward” associated with smoking. The current treatment schedule, which commences 1 week before quitting, relies primarily on the first mechanism. We set out to determine whether increasing the prequit medication period renders cigarettes less satisfying and facilitates quitting.
Methods: One hundred one smokers attending a stop-smoking clinic in London, United Kingdom, were randomly allocated to receive varenicline for 4 weeks before the target quit date (TQD) or to receive placebo for 3 weeks before the TQD, followed by varenicline for 1 week before the TQD. In both groups, standard varenicline treatment was given for 3 months after the TQD. Measures included smoking satisfaction and smoke intake before quitting, urges to smoke and withdrawal discomfort after quitting, and sustained abstinence from the TQD to 3 months.
Results: Varenicline preloading reduced prequit enjoyment of smoking (P = .004) and smoke intake (P < .001), with 36.7% of participants reducing their cotinine concentrations by more than 50% (reducers). Varenicline preloading did not affect postquit withdrawal symptoms, but it increased 12-week abstinence rates (47.2% in the varenicline arm vs 20.8% in the placebo arm, P = .005). The effect was particularly strong among the reducers in the varenicline arm (66.7% in reducers vs 22.6% in nonreducers, P = .002). Varenicline preloading was well tolerated.
Conclusions: Although several issues remain to be clarified, varenicline preloading can generate a substantial reduction in ad lib smoking and enhance 12-week quit rates. Current treatment schedules may lead to suboptimal treatment results. Trials with longer follow-up periods are needed to corroborate these findings.
The bottom line here is that impressive 12-week improvement of 47% of medicine-takers still not smoking, versus only 20% of the placebo-takers still abstinent.
Of course, these medicines are prescription-only because they do have side effects, and they may not be the best option for everyone. But they varenicline was a big advance in medical therapy, and I urge all smokers — or loved ones of smokers — to talk to your family doctors about these newer options.
For more information on World No Tobacco Day, please check out the World Health Organization’s website.
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“Adverse event data from the third quarter of 2010 show the risks of serious psychiatric side effects of Chantix, the smoking-cessation drug, were previously underestimated because Pfizer apparently failed to correctly submit hundreds of these episodes to the FDA, according to an analysis by the Institute for Safe Medicine Practices, a non-profit that regulary reviews the FDA adverse event database.
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I’m not “against” this drug, I swear! I just keep seeing things in newsletters and think the average Joe should really have an informed decision before deciding to take it.
new study- 14% of Chantix users were still not smoking at 24 weeks. Not a great success rate…the marketing materials by Champix people measure smoking status at 12 weeks, showing a higher “success” rate.
as of May 19, 2011, the U.S. FDA has now received a total of 272 reports of completed suicides among Chantix users.
Total adverse event reports up to 35,000- roughly 10,000 were serious, disabling or fatal, with 1,055 serious events being reported during the 3rd quarter of 2010.
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Yes, there is some concerning new data these last few weeks, enough so that I will publish a followup piece soon. Overall, I still feel the benefits outweigh the risks.
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