Varenicline’s Release Did Little to Alter National Smoking Cessation Rates
Overall use of smoking pharmacotherapies has gone up only 2.4 percent since the introduction of varenicline in 2006, while successful quit rates have remained flat.
Varenicline (Chantix) joined the list of FDA-approved smoking cessation agents in 2006 amid a backdrop of promising clinical data and a fair amount of marketing.
Yet, according to a recent study comparing the most recent national tobacco use data available with data obtained before varenicline’s release, the introduction of the medication has had little impact on the total number of smokers using cessation pharmacotherapies or on the overall cessation rate.
These findings are par for the course, however, noted Shu-Hong Zhu, Ph.D., who led the population-based study, published August 17 in the journal Tobacco Control.
“We have been looking at data from over the past two decades and so far none of the recent developments in smoking intervention, such as the advent of nicotine replacement therapies or tobacco price increases, has increased the quit rate,” Zhu, a professor of family medicine and public health at the University of California, San Diego, told Psychiatric News.
Varenicline had some elements that hinted it might break this trend and make an impact, Zhu added. The clinical studies that led to its approval suggested it was superior to existing cessation agents. Additionally, the requirement of a prescription would get doctors engaged in the process, and studies have shown that physician involvement can increase the rates of trying to quit.
But when comparing tobacco use survey data from 2003 with data collected from 2010 to 2011, Zhu’s group found the introduction of varenicline was associated with only a 2.4 percent increase in the use of cessation pharmacotherapies (from 28.7 to 31.1 percent), while the overall cessation rate was virtually unchanged (4.5 percent to 4.7 percent).
“This is not in any way saying that varenicline has been a failure,” Zhu said. “On an individual level, it has worked great for many people. At the population level, though, varenicline has only served to replace other pharmacotherapies and change the market share of cessation drugs.”
Specifically, bupropion—another prescribed agent—has been the most affected, with its use among smokers dropping from 9.1 percent in 2003 to 3.5 percent from 2010 to 2011, while 10.9 percent took varenicline from 2010 to 2011.
The analysis explored the effects of age, gender, and ethnicity but found no real trends in these subgroups other than an increase in pharmacotherapy usage among seniors between 2003 and 2011.
Zhu acknowledged that varenicline may have made a positive impact in some other subsets of the population, such as people with psychiatric illnesses among whom smoking is a serious issue; however, his group’s analysis did not have detailed population statistics to explore this.
“There have been reports that varenicline has serious neuropsychiatric effects, but it also has far fewer adverse interactions with other drugs than bupropion, so psychiatrists now have more of a choice when considering a cessation strategy for a patient,” he said.
“However, at a broad level, this work reinforces that it doesn’t necessarily matter how many options to help quitting you have or how well the drug did in clinical studies. We cannot make a national impact unless you have more people who want to quit. And this applies to not only smoking aids, but medications for alcohol and other drugs.”
Zhu’s study was supported by a grant from the National Cancer Institute under the State and Community Tobacco Control Initiative. ■
An abstract of “Quitting Smoking Before and After Varenicline: A Population Study Based on Two Representative Samples of U.S. Smokers” can be accessed here.
Information & Authors
Information
Published In
History
Published online: 30 September 2015
Published in print: September 19, 2015 – October 2, 2015
Keywords
Authors
Metrics & Citations
Metrics
Citations
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
There are no citations for this item
View Options
View options
Get Access
Login options
Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.
Personal login Institutional Login Open Athens loginNot a subscriber?
PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).