July 16, 2008 Six treatments for smoking cessation perform better than placebos -- including varenicline (Chantix®), recently approved for use in Canada -- states a team of researchers from McGill University and the University of Montreal.
This meta-analysis of placebo-controlled randomized controlled trials totaling 32,000 participants found that varenicline, nicotine nasal spray, bupropion (Wellbutrin®), nicotine patches, tablets and gum helped people quit smoking. However, "despite the documented efficacy of these agents, the absolute number of patients who were abstinent from smoking at 12 months was low."
According to the authors, varenicline was about twice as effective as bupropion.
The authors caution that "despite the efficacy of these pharmacotherapies, the number of patients who remained abstinent from smoking at follow-up was low." They stress more work needs to be done in developing improved therapies to help people quit smoking and to "identify optimal cessation strategies, including alternative ways to use existing agents."
In a related commentary, Mayo Clinic researchers (Dr. J.Taylor Hays through Mayo Clinic Public Affairs, 507-284-5005) state that effective strategies to communicate options to stop smoking need to be developed. "We are confident that the recommended treatments will substantially increase rates of smoking abstinence when given to smokers who wish to quit," yet there are barriers to these treatments. They cite an inability to translate and communicate research findings to the general population. Better programs to disseminate smoking cessation therapies to smokers need to be developed.
Free nicotine replacement therapy could reap major benefits in helping people stop smoking, states Dr. John Cunningham of Toronto's Centre for Addiction and Mental Health in a research letter. He writes this could have major policy implications.
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- Mark J. Eisenberg et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. Canadian Medical Association Journal, July 15, 2008; 179 (2) DOI: 10.1503/cmaj.070256
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