Two Methods Better Than One to Quit Smoking

Quitting smoking was more successful using varenicline and patch

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Quitting smoking can be one of the toughest battles a person can face, but a variety of treatments can help. Sometimes combining treatments may work too.

A recent study found that combining the nicotine patch with the medication varenicline (brand name Chantix) led to better quit rates than just varenicline alone.

Varenicline is a medication used to help individuals quit smoking.

More than half the participants using the patch and varenicline had quit by the third month of treatment. They also had better long-term quit rates.

"Ask your primary care doctor for advice on quitting smoking."

This study, led by Coenraad F. N. Koegelenberg, MD, PhD, of Stellenbosch University in Cape Town, South Africa, looked at whether combining the nicotine patch and the medication varenicline was effective in helping individuals quit smoking safely.

The researchers conducted a trial with 446 smokers who were otherwise healthy and wanted to quit. By the end of the study, 435 remained involved.

The smokers were enrolled at one of seven centers in South Africa between April 2011 and October 2012 and participated in a 12-week treatment program and a 12-week follow-up afterward.

Half the participants wore a nicotine patch starting two weeks before the date they planned to quit smoking.

The other half wore a patch that had no active ingredients, but participants did not know whether they had the real patch or the placebo patch.

One week before their target quit date, all the participants began taking varenicline, which continued for 12 weeks before they began tapering off during the 13th week.

Participants who were considered to have successfully quit smoking were those who abstained from smoking during the last four weeks of treatment, based on a carbon monoxide exhalation test.

The researchers also looked at which smokers remained abstinent six months and two years later.

The results revealed that participants who used both the patch and varenicline had better success than those only using varenicline.

While 55 percent of those using both quit methods had successfully quit smoking, only 41 percent of those using only varenicline had.

At six months after the trial, 65 percent of those who had used varenicline and the patch were not smoking, compared to 47 percent of those who used only varenicline by itself.

Even two years out, the two-method folks had better results. About a third (33 percent) of those using only varenicline were still free of smoking, but 49 percent of those using varenicline and the patch were still smoke-free.

However, the success did not come without side effects. Among those using varenicline and the patch, there was more nausea, sleeping problems, skin reactions, constipation and depression.

However, when the researchers calculated the differences between the groups, only the skin reactions appeared to be different enough not to be dismissed due to chance.

About 14 percent of those using two methods had skin reactions, compared with 8 percent of those using only varenicline.

Meanwhile, the group using only varenicline appeared to experience more headaches and abnormal dreams.

The researchers concluded that using varenicline along with the nicotine patch may be a more effective way to quit smoking than to use only the varenicline alone.

This study was published July 8 in the journal JAMA.

The research was funded by Pfizer and McNeil. The varenicline was supplied by Pfizer and the NRT patches (real and placebo) were provided by McNeil.

Eight of the authors reported various financial relationship with most of the major pharmaceutical companies, including receiving research support, doing consulting and serving on advisory boards.

Review Date: 
July 8, 2014
Last Updated:
July 8, 2014