Effectiveness of Varenicline versus Combination Nicotine Replacement Therapy for Smoking Cessation: One Year Outcomes in a Smoking Cessation Clinic in Taiwan.

Abstract

INTRODUCTION\nVarenicline and combination nicotine replacement treatment (cNRT) have been recommended as the most effective pharmacotherapies, with equal abstinence rate for smoking cessation in a network meta-analysis of randomized trials, but data from real-world long-term follow-up studies are rare. This study aimed to compare the 12-month sustained abstinence rates of smokers using varenicline versus cNRT in their quit attempt.\n\n\nMETHODS\nA total of 3,569 smokers were recruited via the Department of Family Medicine outpatient department at Kaohsiung Veteran General Hospital between June 2013 and March 2019. Participants received counseling from a physician and chose either varenicline (N=2,870) or cNRT (N=699) for smoking cessation. Both varenicline and cNRT users could receive a free 8-week supply and 8 clinic visits over 90 days. Participants were followed-up by telephone at 12, 24, and 52 weeks from first visit. The primary outcome measure of the study was self-reported sustained abstinence up to 52 weeks.\n\n\nRESULTS\nVarenicline users had a significantly higher sustained abstinence rate weeks 12-52, adjusted for baseline variables (15.2% vs. 10.3%, p=0.001; aOR= 1.47, 95%CI: 1.05-2.05). Other significant predictors of 52 weeks sustained abstinence were being male, having a higher income, attending more clinical visits and have lower nicotine dependence.\n\n\nCONCLUSION\nVarenicline appears to have higher sustained abstinence rates to 52 weeks compared with cNRT, in a smoking cessation clinic where smokers can choose their medication option.