Effectiveness of stop‐smoking medications: findings from the International Tobacco Control (ITC) Four Country Survey

Abstract

Aim To evaluate the population effectiveness of stop-smoking medications while accounting for potential recall bias by controlling for quit attempt recency. Design Prospective cohort survey. Setting United Kingdom, Canada, Australia, and the United States. Participants 7,436 adult smokers (18+ years), selected via random digit dialling and interviewed as part of the International Tobacco Control Four Country Survey (ITC-4) between 2002 and 2009. Primary analyses utilized the subset of respondents who participated in 2006 or later (N = 2,550). Measurements Continuous abstinence from smoking for one month/six months. Findings Among participants who recalled making a quit attempt within one month of interview, those who reported using varenicline, bupropion, or the nicotine patch were more likely to maintain six-month continuous abstinence from smoking compared to those who attempted to quit without medication (adjusted OR (95% CI): 5.84 (2.12 – 16.12), 3.94 (0.87 – 17.80), 4.09 (1.72 – 9.74), respectively); there were no clear effects for oral NRT use. Those who did not use any medication when attempting to quit tended to be younger, to be racial/ethnic minorities, to have lower incomes, and to believe that medications do not make quitting easier. Conclusions Consistent with evidence from randomized controlled trials, smokers in the UK, Canada, Australia, and the US are more likely to succeed in quit attempts if they use varenicline, bupropion or nicotine patch. Previous population studies that failed to find an effect failed to adjust adequately for important sources of bias.

‘Real-world’ effectiveness of smoking cessation treatments: a population study

“…We avoided this by using a validated measure involving ratings of current urges to smoke and adjust statistically for whether this was during normal smoking or a period of abstinence [32]. However, our findings with regard to medication are consistent with many prospective real-world studies [18,21,25,[35][36][37][38].…”

Quitting smoking: experiences from the Southwestern region, Saudi Arabia

“…There are many studies that have reported increased cessation rates with the use of pharmacotherapy [24,25], but in the current study, more than three quarters of those who tried to quit smoking were not using any medication to stop smoking. Among those who used medication (n=125), verincline was the most frequently used drug (54.4%).…”

Varenicline-Induced Elevation of Dopamine in Smokers: A Preliminary [11C]-(+)-PHNO PET Study

“…This is compelling as it suggests that varenicline may act to alter the brain and subjective response prior to quitting, thus enabling the mechanism by which smokers may subsequently quit. It may also explain the delayed quitting observed up to 4 weeks after taking varenicline (Agboola et al, 2010(Agboola et al, , 2015Kasza et al, 2013). It has been shown that treatment with the nicotine patch prior to the quit date can improve smoking cessation (Rose et al, 2009); in smokers who did not decrease smoking prior to their quit date while undergoing nicotine replacement therapy, they could be 'rescued' by bupropion augmentation of the patch or with varenicline treatment alone (Rose and Behm, 2013).…”