BACKGROUND: Existing trials of varenicline have typically excluded smokers with concurrent medical and psychiatric illnesses and no data exist comparing effectiveness of varenicline with combination pharmacotherapy. This study evaluated abstinence and psychiatric outcomes of various tobacco dependence medications, including varenicline. METHODS: Retrospective cohort of 723 smokers, most with significant medical and psychiatric comorbidity, was evaluated at the UMDNJ-Tobacco Dependence Clinic from 2006 to 2008. Demographics, measures of tobacco dependence and co-morbidities, and a validated instrument measuring psychological distress (Kessler-6) were obtained. Primary outcome was 7-day point abstinence at 6 months after target quit date. RESULTS: Cessation medications used included combination pharmacotherapy (39%), single nicotine replacement therapy (NRT) or bupropion (29%), and varenicline (23%), with 9% using no medications. Overall, 23% of patients were abstinent at 6 months. In an adjusted regression model, smokers using varenicline or combination medications were more likely abstinent at 6 months than those using no medications (adjusted odds ratio=2.99; 95% confidence interval=1.20-7.47 and 2.80; 1.15-6.82, respectively), but not statistically higher than those using single medications (AOR=1.70). Age, gender, education, marital status, cigarettes per day, time to first cigarette, night smoking, and menthol smoking were not significantly related to abstinence. Varenicline or combination medications did not significantly increase serious psychological distress over the treatment period compared to other medication options. CONCLUSIONS: Both varenicline and combination pharmacotherapy were effective and did not increase psychological distress for up to 6 months in smokers with co-morbidities treated at a specialty clinic.
BACKGROUND: Existing trials of varenicline have typically excluded smokers with concurrent medical and psychiatric illnesses and no data exist comparing effectiveness of varenicline with combination pharmacotherapy. This study evaluated abstinence and psychiatric outcomes of various tobacco dependence medications, including varenicline. METHODS: Retrospective cohort of 723 smokers, most with significant medical and psychiatric comorbidity, was evaluated at the UMDNJ-Tobacco Dependence Clinic from 2006 to 2008. Demographics, measures of tobacco dependence and co-morbidities, and a validated instrument measuring psychological distress (Kessler-6) were obtained. Primary outcome was 7-day point abstinence at 6 months after target quit date. RESULTS: Cessation medications used included combination pharmacotherapy (39%), single nicotine replacement therapy (NRT) or bupropion (29%), and varenicline (23%), with 9% using no medications. Overall, 23% of patients were abstinent at 6 months. In an adjusted regression model, smokers using varenicline or combination medications were more likely abstinent at 6 months than those using no medications (adjusted odds ratio=2.99; 95% confidence interval=1.20-7.47 and 2.80; 1.15-6.82, respectively), but not statistically higher than those using single medications (AOR=1.70). Age, gender, education, marital status, cigarettes per day, time to first cigarette, night smoking, and menthol smoking were not significantly related to abstinence. Varenicline or combination medications did not significantly increase serious psychological distress over the treatment period compared to other medication options. CONCLUSIONS: Both varenicline and combination pharmacotherapy were effective and did not increase psychological distress for up to 6 months in smokers with co-morbidities treated at a specialty clinic.
Authors: Sherry A McKee; Andrea H Weinberger; Julia Shi; Jeanette Tetrault; Sabrina Coppola Journal: Nicotine Tob Res Date: 2012-04-06 Impact factor: 4.244
Authors: Philip H Smith; Biruktawit Assefa; Simranpreet Kainth; Kaliris Y Salas-Ramirez; Sherry A McKee; Gary A Giovino Journal: Nicotine Tob Res Date: 2020-03-16 Impact factor: 4.244
Authors: Jill M Williams; Michael B Steinberg; Marc L Steinberg; Kunal K Gandhi; Rajiv Ulpe; Jonathan Foulds Journal: Expert Opin Pharmacother Date: 2011-06-06 Impact factor: 3.889
Authors: Lauren J Lee; Qian Li; Marianna Bruno; Birol Emir; Brian Murphy; Surbhi Shah; Matthew Reynolds; Nick Marchant; Peter W Park Journal: Adv Ther Date: 2018-12-19 Impact factor: 3.845