Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Smoking Cessation Treatment and Management Center of Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Nicotine Tob Res. 2021 Jun 8;23(7):1094-1102. doi: 10.1093/ntr/ntab018.
Varenicline and combination nicotine replacement treatment (cNRT) have been recommended as the most effective pharmacotherapies, with equal abstinence rate for smoking cessation in a network meta-analysis of randomized trials, but data from real-world long-term follow-up studies are rare. This study aimed to compare the 12-month sustained abstinence rates of smokers using varenicline versus cNRT in their quit attempt.
A total of 3569 smokers were recruited via the Department of Family Medicine outpatient department at Kaohsiung Veteran General Hospital between June 2013 and March 2019. Participants received counseling from a physician and chose either varenicline (N = 2870) or cNRT (N = 699) for smoking cessation. Both varenicline and cNRT users could receive a free 8-week supply and eight clinic visits over 90 days. Participants were followed-up by telephone at 12, 24, and 52 weeks from first visit. The primary outcome measure of the study was self-reported sustained abstinence up to 52 weeks.
Varenicline users had a significantly higher sustained abstinence rate at weeks 12-52, adjusted for baseline variables (15.2% vs 10.3%, p = .001; adjusted odds ratio = 1.47, 95% confidence interval: 1.05-2.05). Other significant predictors of 52 weeks sustained abstinence were being male, having a higher income, attending more clinical visits, and have lower nicotine dependence.
Varenicline appears to have higher sustained abstinence rates to 52 weeks compared with cNRT, in a smoking cessation clinic where smokers can choose their medication option.
Network meta-analysis of randomized trials suggests that varenicline and cNRT are similarly effective for smoking cessation. This study shows that 1-year sustained abstinence rates were significantly higher among smokers using varenicline, compared with smokers using cNRT, when used as part of a structured smoking cessation program. These findings are highly relevant to policy makers and service providers to help determine provision of smoking cessation treatment.
在随机试验的网络荟萃分析中，伐伦克林和尼古丁替代联合治疗（cNRT）被推荐为最有效的药物治疗方法，戒烟成功率相当，但来自真实世界长期随访研究的数据很少。本研究旨在比较戒烟尝试中使用伐伦克林与 cNRT 的吸烟者 12 个月持续戒烟率。
2013 年 6 月至 2019 年 3 月，通过高雄荣民总医院家庭医学科门诊共招募了 3569 名吸烟者。参与者接受了医生的咨询，并选择伐伦克林（N=2870）或 cNRT（N=699）进行戒烟。伐伦克林和 cNRT 使用者都可以获得免费的 8 周供应和 90 天内 8 次就诊。参与者在首次就诊后 12、24 和 52 周通过电话进行随访。本研究的主要结局指标是在 52 周内自我报告的持续戒烟。
调整基线变量后，伐伦克林使用者在 12-52 周时的持续戒烟率显著更高（15.2%比 10.3%，p=0.001；调整后的优势比=1.47，95%置信区间：1.05-2.05）。52 周持续戒烟的其他显著预测因素是男性、收入较高、就诊次数较多和尼古丁依赖程度较低。
在一个吸烟者可以选择药物的戒烟诊所中，伐伦克林似乎比 cNRT 有更高的 52 周持续戒烟率。
随机试验的网络荟萃分析表明，伐伦克林和 cNRT 在戒烟方面同样有效。本研究表明，在作为结构化戒烟计划的一部分使用时，与使用 cNRT 的吸烟者相比，使用伐伦克林的吸烟者 1 年持续戒烟率显著更高。这些发现与决策者和服务提供者密切相关，有助于确定戒烟治疗的提供。
