Tuberc Respir Dis.  2012 May;72(5):426-432.

Adherence to Varenicline and Abstinence Rates for Quitting Smoking in a Private Health Promotion Center-Based Smoking Cessation Clinic

• Lee JY
• Kim MJ
• Jun HJ
• Kang M
• Park AR
• Oh DE
• Choi YH
• Hwang JH

Abstract

BACKGROUND
Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation.
METHODS
This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009.
RESULTS
The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found.
CONCLUSION
If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.

Keyword

Smoking Cessation; Varenicline; Medication Adherence

MeSH Terms

Benzazepines
Compliance
Health Promotion
Humans
Male
Medication Adherence
Odds Ratio
Quinoxalines
Retrospective Studies
Smoke
Smoking
Smoking Cessation
Varenicline
Benzazepines
Quinoxalines
Smoke

Reference

1. Smoking statistics: illness and death [Internet]. Action on Smoking and Health. 2011. cited 2011 Oct 23. London: Action on Smoking and Health;Available from: http://www.ash.org.uk/files/documents/ASH_107.pdf.

2. Kim IS, Jee SH, Ohrr H, Yi SW. Effects of smoking on the mortality of lung cancer in Korean men. Yonsei Med J. 2001. 42:155–160.

3. The Forth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. 2009. cited 2011 Oct 23. Seoul: Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention;Available from: http://knhanes.cdc.go.kr.

4. Watkins SS, Koob GF, Markou A. Neural mechanisms underlying nicotine addiction: acute positive reinforcement and withdrawal. Nicotine Tob Res. 2000. 2:19–37.

5. Zbikowski SM, Swan GE, McClure JB. Cigarette smoking and nicotine dependence. Med Clin North Am. 2004. 88:1453–1465. x

6. Tonstad S. Smoking cessation efficacy and safety of varenicline, an alpha4beta2 nicotinic receptor partial agonist. J Cardiovasc Nurs. 2006. 21:433–436.

7. Nides M, Oncken C, Gonzales D, Rennard S, Watsky EJ, Anziano R, et al. Smoking cessation with varenicline, a selective alpha4beta2 nicotinic receptor partial agonist: results from a 7-week, randomized, placebo- and bupropion-controlled trial with 1-year follow-up. Arch Intern Med. 2006. 166:1561–1568.

8. Tonstad S. Varenicline for smoking cessation. Expert Rev Neurother. 2007. 7:121–127.

9. Tsai ST, Cho HJ, Cheng HS, Kim CH, Hsueh KC, Billing CB Jr, et al. A randomized, placebo-controlled trial of varenicline, a selective alpha4beta2 nicotinic acetylcholine receptor partial agonist, as a new therapy for smoking cessation in Asian smokers. Clin Ther. 2007. 29:1027–1039.

10. Kang YS, Choi SY, Ryu E. The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse Educ Today. 2009. 29:538–543.

11. Ockene IS, Miller NH. American Heart Association Task Force on Risk Reduction. Cigarette smoking, cardiovascular disease, and stroke: a statement for healthcare professionals from the American Heart Association. Circulation. 1997. 96:3243–3247.

12. Shinton R, Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989. 298:789–794.

13. Critchley JA, Capewell S. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA. 2003. 290:86–97.

14. Enstrom JE, Heath CW Jr. Smoking cessation and mortality trends among 118,000 Californians, 1960-1997. Epidemiology. 1999. 10:500–512.

15. Molyneux A. Nicotine replacement therapy. BMJ. 2004. 328:454–456.

16. Fiore MC, Novotny TE, Pierce JP, Giovino GA, Hatziandreu EJ, Newcomb PA, et al. Methods used to quit smoking in the United States. Do cessation programs help? JAMA. 1990. 263:2760–2765.

17. Laviolette SR, van der Kooy D. The neurobiology of nicotine addiction: bridging the gap from molecules to behaviour. Nat Rev Neurosci. 2004. 5:55–65.

18. Garrison GD, Dugan SE. Varenicline: a first-line treatment option for smoking cessation. Clin Ther. 2009. 31:463–491.

19. Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, et al. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA. 2006. 296:47–55.

20. Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006. 296:56–63.

21. Tonstad S, Tønnesen P, Hajek P, Williams KE, Billing CB, Reeves KR, et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA. 2006. 296:64–71.

22. Wang C, Xiao D, Chan KP, Pothirat C, Garza D, Davies S. Varenicline for smoking cessation: a placebo-controlled, randomized study. Respirology. 2009. 14:384–392.

23. Song B, Yun WS, Choi EY, Cheong YS, Park EW. Smoking cessation rate and related factors of varenicline in clinical practice. Korean J Fam Med. 2011. 32:112–119.