Varenicline Therapy For Smoking Cessation Research Articles

Evaluation of factors affecting smoking cessation in people treated with Varenicline

Objective: Aim of the study is to evaluate factors affecting treatment success among individuals receiving varenicline therapy for smoking cessation. Material and Methods: This research was carried out at Istanbul Medeniyet University Göztepe Training and Research Hospital between January 2018 and January 2019. A total of 209 patients in the smoking cessation outpatient clinic who were treated with varenicline Varenicline were constituted into the study group. The Fagerstrom Nicotine Dependence Level Test (FTND) was used to determine individuals' nicotine addiction levels, and the Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression levels. Results: There were 90 (43.1%) women and 119 (56.9%) men in the study group and mean age was 41.34 ± 10.93 (21-64) years. Overall, 63.2% (n=132) of varenicline recipients quit smoking. The frequency of quitting smoking due to physician advice was higher in those who quit than those who did not (p=0.011). Multiple logistic regression revealed that the independent factors associated with the lower likelihood of smoking cessation were higher number of cigarettes per day (p=0.008), higher HADS-Total score (p<0.001), post-treatment nervousness (p=0.046), and post-treatment depressive mood (p=0.007), whereas being able to remain smoke-free for longer periods in previous quitting attempts was associated with higher likelihood of success (p=0.005). Conclusion: The success of smoking cessation with varenicline therapy is lower in the presence of the following factors: having high risk for anxiety and depression, smoking a greater number of cigarettes per day, shorter periods of remaining smoke-free in previous quitting attempts, and experiencing nervousness during withdrawal. Receiving physician advice to quit also appears to increase the chance of quitting smoking. Keywords: Smoking; Smoking Cessation; Smoking Cessation Agents; Varenicline; Anxiety; Depression

A Randomised Controlled Trial Evaluating the Effectiveness and Tolerability of Step-up and Step-down Varenicline Therapy for Smoking Cessation: A Study Protocol

Background: Varenicline remains the most effective medication for smoking cessation; however, discontinuation as a result of adverse events negatively impacts medication adherence, and the likelihood of a quit attempt being successful. Post-treatment cravings and withdrawal symptoms may also occur, increasing the likelihood of treatment failure, due to lapse and relapse after achieving initial abstinence. This protocol details a trial investigating changes in the effectiveness and tolerability of varenicline, when an extended step-up and step-down regimen are used.Methods: A phase four, randomised, double-blinded, placebo-controlled single-centre study with a treatment period of 16 weeks, and follow-up period of 12 weeks will be conducted. Up to 201 participants will be enrolled and allocated in a 1:1:1 ratio to a placebo-matching control group, step-up, or step-down intervention group, all receiving behavioural counselling and quitting advice. Participants will be contacted weekly during treatment and fortnightly during follow-up. Eligible participants are smokers over 18 years old, willing to quit smoking, are able to attend clinic visits, and have no uncontrolled or serious medical issues. Primary outcome measures are comparisons of biochemically confirmed continuous abstinence rates, 7-day point prevalence abstinence rates, and the frequency, severity and duration of adverse events, cravings and withdrawal symptoms. Secondary outcome measures are participant adherence to the study medication throughout treatment, and comparisons of changes in smoking satisfaction and reward. Effects of each regimen on smoking cessation will be assessed by logistic regression, with survival analyses used for a more precise estimate of when cessation occurs. Primary endpoints will then be compared using a general linear model. Australian New Zealand Clinical Trials Registry: ACTRN12616000802404p

Assessing GP use of varenicline therapy for smoking cessation

Smoking cessation is an important public health policy in reducing premature mortality in people with risk factors or comorbidities. Varenicline is the most effective therapy for sustained cessation, but it is not used as widely as nicotine replacement therapy.

Effektivität und Sicherheit von Vareniclin zur Raucherentwöhnung

Smoking is one of the major avoidable risks for mortality and morbidity. Thus developing new strategies for smoking cessation is a crucial medical challenge. Varenicline is an α4β2 nicotinic acetylcholine receptor partial agonist developed especially for smoking cessation. Several trials proved the efficacy of varenicline and its superiority to other medications for smoking cessation (bupropion and nicotine replacement therapy). Varenicline was associated with severe cardiovascular and neuro-psychiatric side effects. This article discusses the current research data on efficacy and safety of varenicline therapy for smoking cessation.