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Chantix gradually increases smoking cessation rates

Chantix helped more smokers to reduce gradually the number of cigarettes they smoked daily and eventually to quit compared with placebo, according to study results.

“Because most clinicians are likely to see smokers at times when a quit date in the next month is not planned, the current study indicates that the prescription of varenicline with a recommendation to reduce the number of cigarettes smoked per day with the eventual goal of quitting could be a useful therapeutic option for this population of smokers,” Jon O. Ebbert, MD, MSc, of Mayo Clinic in Rochester, Minnesota, and colleagues, wrote.

Ebbert and colleagues conducted a randomized, double blind, placebo-controlled, multinational clinical trial with a 24-week treatment period and 28-week follow-up conducted between July 2011 and July 2013 at 61 centers in 10 countries. The desired outcome was to calculate the efficacy and safety of Chantix (varenicline, Pfizer) for increasing smoking abstinence rates through smoking reduction.

Participants (n = 1,510) were randomly assigned varenicline (n = 760) or placebo for 24 weeks and were asked to reduce their baseline smoking rate by 50% or more by week 4 with continued reduction to 75% or more by week 8. The goal was to quit smoking by week 12.

Smokers assigned varenicline began treatment with a dosage of 0.5 mg once daily for the first 3 days and increased it to twice daily for the next 4 days followed by a maintenance dose of 1 mg twice daily.

The varenicline group had greater continuous abstinence rates during weeks 15 through 24 than the placebo group (32.1% vs. 6.9%; RR = 4.6; 95% CI, 3.5-6.1). The abstinence rates during weeks 21 through 52 also remained higher in the varenicline group compared with placebo (27% vs. 9.9%; RR = 2.7; 95% CI, 2.1-3.5). The incidence rate of serious adverse events between groups was not significant.

“Among cigarette smokers not willing or able to quit within the next month but willing to reduce cigarette consumption and make a quit attempt at 3 months, use of varenicline for 24 weeks compared with placebo significantly increased smoking cessation rates at the end of treatment, and also at 1 year,” the researchers wrote. – by Ryan McDonald

Disclosure: Ebbert reports receiving grants from JHP Pharmaceuticals, NIH, Orexigen and Pfizer. Ebbert also reports receiving personal fees from GlaxoSmithKline during the study. Please see the full study for a list of all other authors’ relevant financial disclosures.