A recent study shows that nicotine replacement therapy and varenicline trumps the nicotine patch alone as effective treatment options.
Smoking remains prevalent worldwide and anyone who has tried to quit can attest to the fact that it can be difficult. Forty percent of smokers try to quit at least twice annually but only 3-5% are successful. A recent study examined the effectiveness of the standard nicotine patch (NRT), nicotine replacement therapy (NRT+) and varenicline (VR, a prescription medication).
A total of 737 smokers were randomly divided into one of three treatment groups. The NRT group received 10 weeks of Nicoderm patches (21 mg daily maximum), the NRT+ group received Nicoderm patches (35 mg daily maximum) plus Nicorette gum or inhaler for up to 22 weeks, and the VR group received 1 mg of Champix twice daily for up to 24 weeks. All participants received six 15 min smoking cessation counselling sessions. Â Continuous abstinence rates (CAR) were confirmed by measuring exhaled carbon monoxide levels during weeks 5-52. A participant was considered to be abstinent if they smoked a maximum of 5 cigarettes during the 5-52 week time period and exhaled CO levels of less than 9ppm at the 52 week visit. CARs were also assessed between weeks 5-10 and 5-22.
For weeks 5-52, participants taking varenicline had the highest abstinence rate and those receiving only patches had the lowest. Participants receiving patches plus gum or inhaler for 22 weeks or varenicline alone were more likely to refrain from smoking between weeks 5-10. Those receiving only varenicline were more likely to abstain from smoking between weeks 5-22. Taken together, the results demonstrate that varenicline alone or a combination of patches and gum/inhaler appeared to be the most effective treatment for cessation of smoking.
Nicotine patches and nicotine replacement therapy were associated with skin problems when compared to participants taking varenicline. Side effects associated with varenicline were fatigue, sleep and digestive problems.
Nicotine replacement therapy and varenicline are the most effective methods of quitting short term but not as effective long term.
Written By: Aurelie Hartawidjojo, BSc, BScPT
