31 Dec Increasing Chantix Dose Did Not Increase Smoking Quit Rate
MedicalResearch.com Interview with:
Dr Hayden McRobbie MB ChB PhD
Reader in Public Health Interventions
Wolfson Institute of Preventive Medicine
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
Medical Research: What is the background for this study? What are the main findings?
Dr. McRobbi: Varenicline is an effective smoking cessation aid that acts primarily to alleviate the symptoms of tobacco withdrawal discomfort, thereby making quitting easier. It also reduces the rewarding effects of cigarettes smoked which may enhance the drugs smoking cessation effect by reducing the enjoyment of smoking prior to quitting and preventing a lapse, after quitting, progressing to relapse.
In some people the standard dose of varenicline (2mg/day) results in a decrease in the enjoyment of smoking prior to quitting and that these people appear to have higher quit rates that those that don’t experience this reaction to smoking.
The randomised placebo controlled trial was designed to investigate whether increasing the varenicline dose (up to 5mg/day) in smokers who show no reaction to the standard dose improves treatment outcomes compared to remain on the standard dose.
Medical Research: What are the main findings?
Dr. McRobbi: Whilst the increased dose, compared with the standard dose, reduced the enjoyment of smoking prior to quitting it had no additional effect on alleviating tobacco withdrawal symptoms or smoking cessation rates at 12 weeks post quit date (26% vs. 23%).
Medical Research: What should clinicians and patients take away from your report?
Dr. McRobbi: It is reasonably common for clinicians to consider dose increases for treatments when there is no response to the standard dose. However this approach may not work with varenicline. Clinicians should continue to use the standard dose (2mg/day) and recommend that patients use this medicine in combination with behavioural support. The latter will help them address some of the other difficulties associated with stopping smoking. Clinicians can reassure patients who feel that the medicine is not working for them that not everyone experiences reduced enjoyment of smoking and that its main effect is to help alleviate craving and other withdrawal symptoms when they stop smoking. However, like all smoking cessation medicines, it is no magic cure.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. McRobbi: Other approaches to increase varenicline efficacy such as longer pre-loading to reduce smoking rewards and facilitate quitting seem more promising and deserve further studies.
Citation:
Last Updated on December 31, 2014 by Marie Benz MD FAAD