OTC nicotine patch as effective as smoking cessation medicines, study finds
CHICAGO - Among adults motivated to quit smoking, 12 weeks of treatment with a nicotine patch, the drug varenicline or combination nicotine replacement therapy produced no significant differences in confirmed rates of smoking abstinence at 26 or 52 weeks, raising questions about the current relative effectiveness of intense smoking cessation pharmacotherapies, according to a study in the Jan. 26 issue of JAMA.
The researchers found that the treatments did not differ significantly on any abstinence outcome measure at 26 or 52 weeks, including point-prevalence abstinence at 26 weeks (nicotine patch, 23%; varenicline, 24%; C-NRT, 27%) or at 52 weeks (nicotine patch, 21%; varenicline, 19% percent; C-NRT, 20%).
“To our knowledge, this open-label study is the first to directly contrast varenicline and C-NRT pharmacotherapies, both with one another and with the nicotine patch," noted Timothy Baker, lead researcher from the University of Wisconsin School of Medicine and Public Health. "Results showed no significant differences among these 3 pharmacotherapies in any of the 26- or 52-week abstinence measures.”
All medications were well tolerated, but varenicline produced more frequent adverse events than did the nicotine patch for vivid dreams, insomnia, nausea, constipation, sleepiness and indigestion.
Due to the profound health effects of tobacco smoking, it is important to identify treatments that increase rates of long-term smoking abstinence. Two pharmacotherapies for smoking seem particularly effective: combination nicotine replacement therapy and varenicline. Because varenicline and C-NRT differ in cost, the need for a prescription, and the intensity of screening and ongoing monitoring, a comparison in a head-to-head randomized clinical trial appeared warranted, Baker asserted, as does the need to test their effectiveness relative to nicotine patch monotherapy, which might be considered a usual-care smoking cessation medication.