Effects of aging on the effectiveness of smoking cessation medication

Abstract

BackgroundConsidering the pharmacokinetic and pharmacodynamic aspects of different medications, it is plausible that the age of a smoker could affect the half-life of these drugs. The aim of this study was to compare the effectiveness of smoking cessation drugs (nicotine replacement therapy, bupropion, and varenicline) used either in isolation or in combination in adults under and over 60 years of age.MethodsData were collected from 940 Brazilian patients participating in a smoking cessation program. Participants were prescribed smoking cessation medication to be used for at least 12 weeks and were followed for 52 weeks.ResultsCessation rates were significantly different among younger and older participants who were using nicotine replacement therapy (NRT) alone. Being over 60 years of age was significantly associated with increased cessation success among those who used NRT alone (OR 2.34, 95% CI: 1.36 to 4.04, p = 0.002). The effectiveness of varenicline and bupropion were not significantly different according to age groups.ConclusionUsing age as a predictor for tailoring smoking cessation drugs might potentially lead to a more individualized prescription of smoking cessation therapy. These results should be tested in randomized controlled trials.

Comparative Effectiveness of Varenicline and Nicotine Replacement Therapy for Smoking Cessation in Older and Younger Smokers: A Prospective Cohort in Taiwan

“…A similar age-dependent pattern in abstinence rates for NRT users was also observed in a Brazilian cohort. 21…”

Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

“…One possibility to increase reach for varenicline would be to lower costs and/or access restrictions 46. In contrast to standard NRT, where effectiveness increases with age, varenicline seems equally effective in younger and older people 47. Moreover, in a real‐world setting, varenicline together with specialist behavioural support was very effective 24, 48 and thus offers potential for transferring this evidence outside study environments.…”

Profile of the Nicotinic Cholinergic Receptor Alpha 7 Subunit Gene Expression is Associated with Response to Varenicline Treatment

“…Exclusion criteria were: patients with hepatic, renal and gastrointestinal disorders that compromised drug metabolism and elimination; patients who had taken cytochrome P450 enzymeinducing or inhibiting drugs in the previous 6 weeks; alcoholic patients and drug users; those with unstable psychiatric illnesses; women at risk of pregnancy; patients with contraindications to the treatment with varenicline mentioned above. Interindividual variability in response to drugs for smoking cessation suggests that treatments may be more effective in subgroups of smokers [12][13][14][15]. In the context of personalized medicine, researchers have sought to identify predictors of response to smoking cessation treatments, which are generally involved in pharmacokinetic and/or pharmacodynamic pathways, such as genetic factors, gene expression profiles, proteins and metabolites [16][17][18][19].…”

“…Interindividual variability in response to drugs for smoking cessation suggests that treatments may be more effective in subgroups of smokers [12][13][14][15]. In the context of personalized medicine, researchers have sought to identify predictors of response to smoking cessation treatments, which are generally involved in pharmacokinetic and/or pharmacodynamic pathways, such as genetic factors, gene expression profiles, proteins and metabolites [16][17][18][19].…”