Hsueh Kuang-Chieh, Hsueh Shu-Chun, Chou Ming-Yueh, Pan Lee-Fei, Tu Ming-Shium, McEwen Andy, West Robert
Department of Family Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung First Road, Kaohsiung, 813, Taiwan,
Psychopharmacology (Berl). 2014 Jul;231(14):2819-23. doi: 10.1007/s00213-014-3482-9. Epub 2014 Feb 13.
A network meta-analysis of randomized trials and real-world comparative studies strongly suggest that varenicline is more effective in aiding smoking cessation than single form nicotine replacement therapy (NRT). Modeling the health benefits attributable to this difference relies on extrapolation to lifetime cessation, but to date, follow-up has only extended to 12 months. Longer term follow-up data are helpful in checking these assumptions.
This study aimed to compare the sustained abstinence rates of smokers using varenicline versus nicotine patch in their quit attempt up to 36 months.
Five hundred eighty-seven smokers were recruited at Kaohsiung Veteran General Hospital between Feb 2006 and Aug 2009. Participants received counseling from a physician and received either varenicline (N=296) or the nicotine patch (N=291) for smoking cessation. Both varenicline and nicotine patch users could receive their medications for a maximum of 8 weeks. Participants were followed up by telephone at 3, 6, 12, and 36 months from the first visit. The primary outcome measure was self-reported sustained abstinence up to 36 months. Measures were also taken of smoking characteristics, cigarette dependence, and sociodemographic characteristics.
Multiple logistic regression of 36-month sustained abstinence on to medication adjusting for other baseline variables showed a significant advantage for varenicline, OR=7.94 (95 % CI 1.87-33.74).
An 8-week course of varenicline appears to yield higher abstinence rate up to 3 years than a similar length course of nicotine transdermal patch in routine clinical practice where behavioral support is available.
对随机试验和真实世界比较研究的网络荟萃分析有力地表明，伐尼克兰在辅助戒烟方面比单一形式的尼古丁替代疗法（NRT）更有效。对这种差异所带来的健康益处进行建模依赖于外推至终身戒烟，但迄今为止，随访仅延长至12个月。长期随访数据有助于检验这些假设。
本研究旨在比较使用伐尼克兰与尼古丁贴片进行戒烟尝试的吸烟者长达36个月的持续戒烟率。
2006年2月至2009年8月期间，在高雄荣民总医院招募了587名吸烟者。参与者接受医生的咨询，并接受伐尼克兰（N = 296）或尼古丁贴片（N = 291）进行戒烟。伐尼克兰和尼古丁贴片使用者的用药时间最长可达8周。从首次就诊开始，在3、6、12和36个月通过电话对参与者进行随访。主要结局指标是自我报告的长达36个月的持续戒烟情况。还对吸烟特征、香烟依赖和社会人口统计学特征进行了测量。
在对其他基线变量进行调整后，对36个月持续戒烟情况与用药进行的多因素逻辑回归显示，伐尼克兰具有显著优势，比值比（OR）= 7.94（95%置信区间1.87 - 33.74）。
在可获得行为支持的常规临床实践中，为期8周的伐尼克兰疗程在长达3年的时间里似乎比类似时长的尼古丁透皮贴片疗程产生更高的戒烟率。
