CSD EPIC, London, UK.
Curr Med Res Opin. 2010 Apr;26(4):861-70. doi: 10.1185/03007990903526461.
Varenicline is a licensed smoking cessation medication in the EU, USA and many other countries worldwide. This study was designed to assess its effectiveness in a UK general practice setting.
The main outcome measure was the rate of smoking cessation, defined as the seven-day point prevalence after six months from starting varenicline. Varenicline users were identified from records in The Health Improvement Network (THIN) database. A questionnaire on smoking cessation was sent to patients who commenced treatment close to the selection date (six months prior to the date of questionnaire dispatch).
The response rate was 26.4%: 193 responses were received. Ninety percent had previously attempted to stop smoking and 87.4% had used nicotine replacement therapy during the previous attempt to stop smoking. The overall smoking cessation rate was 49.5%. There was a strong association between the duration of varenicline treatment and smoking cessation. Patients who reported using varenicline for 9-12 weeks were 11 times more likely to stop smoking than those who completed less than two weeks of treatment. There was some evidence that patients with a longer history of smoking were less likely to stop. No association was observed between smoking cessation and: previous number of cigarettes smoked per day; number of previous attempts to stop smoking; or motivations for stopping.
Varenicline appeared to be a useful pharmacological aid to smoking cessation in a general practice setting. The observed effectiveness was similar to the efficacy estimates from previously reported clinical trials. However, the response rate was lower than expected and responders tended to be older, more likely to suffer from chronic obstructive pulmonary disease and to live in more affluent areas than non-responders. Responses were self-reported and not clinically validated therefore recall bias may be an issue.
伐伦克林在欧盟、美国和全球许多其他国家被批准为戒烟药物。本研究旨在评估其在英国常规医疗实践环境中的有效性。
主要结局指标为戒烟率，定义为开始使用伐伦克林后 6 个月的 7 天点患病率。通过 The Health Improvement Network（THIN）数据库中的记录确定伐伦克林使用者。向接近选择日期（在调查问卷发送日期前 6 个月）开始治疗的患者发送戒烟调查问卷。
应答率为 26.4%：收到 193 份回复。90%的患者曾尝试戒烟，87.4%的患者在之前的戒烟尝试中使用过尼古丁替代疗法。总体戒烟率为 49.5%。伐伦克林治疗持续时间与戒烟之间存在很强的关联。报告使用伐伦克林治疗 9-12 周的患者戒烟的可能性是完成少于 2 周治疗的患者的 11 倍。有一些证据表明，吸烟史较长的患者戒烟的可能性较低。戒烟与以下因素之间未观察到关联：每天吸烟的支数、戒烟尝试的次数、或戒烟的动机。
伐伦克林在常规医疗实践环境中似乎是一种有用的戒烟药理学辅助手段。观察到的疗效与之前报道的临床试验中的疗效估计相似。然而，应答率低于预期，应答者倾向于比非应答者年龄更大、更可能患有慢性阻塞性肺疾病、生活在更富裕的地区。应答是自我报告的，未经过临床验证，因此可能存在回忆偏倚的问题。
