Searching for phenotypes in smoking cessation treatment

Abstract

Summary Background It is important to define smoking phenotypes according to different variables, such as age, sex and degree of dependence, for which available treatments could have different efficacies. Objective The main objective of our study was aimed at defining different combinations of these variables to allow the best possible treatment to be chosen in routine clinical practice. Methods We reviewed the clinical records of smokers who had been treated in our Smoking Cessation Service. In all cases, the treatment programme consisted of a combination of behavioural therapy and optional drug treatment. Results The group consisted of 3622 subjects, specifically 1757 men (48.5%). The mean age of the participants in the group was 48.11 ± 11.19 years. The mean score of the FTCD‐questionnaire was 6.66 ± 2.38. In addition, 78% of the subjects smoked their first cigarette within 30 min after waking. For the total sample, continuous abstinence rate from 9 to 24 weeks was 57.7%. A multivariate analysis using the logistic regression model was implemented, and it showed that: (i) Nicotine Replacement Therapy was less effective in patients with high tobacco dependence, (ii) young subjects can be highly resistant to all treatments and (iii) subjects with low tobacco dependence can be treated with any treatment, but bupropion and varenicline provided the best results. Conclusion It was possible to identify several smoking phenotypes in which different treatments have different efficacies.