Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Prev Med. 2022 Aug;161:107091. doi: 10.1016/j.ypmed.2022.107091. Epub 2022 Jun 3.
Although varenicline has had a significant effect on smoking cessation in randomized clinical trials, the dose-effect of varenicline treatment for smoking cessation in real-world settings remains unclear. This study aimed to evaluate the association between the duration of varenicline prescription and smoking cessation in Taiwan after adjusting for potential confounding effects and endogeneity bias. A total of 5106 Taiwanese participants received varenicline monotherapy for smoking cessation between March 2012 and September 2016. Multinomial logistic regression (MLR) was used to analyze the association between varenicline prescription duration and smoking cessation, stratified by the frequency of smoking clinic visits and propensity scores of early stopping of smoking cessation treatment. Compared to the reference of nonquitting, longer durations of varenicline prescription were associated with the greater likelihood of immediate and complete quitting (OR = 1.08, 95% CI = 1.02-1.14) and late quitting (OR = 1.14, 95% CI = 1.07-1.20). Among those who were more likely to continue visiting smoking clinics, longer use of varenicline was significantly associated with an increase in immediate-and-complete quitting (OR = 1.19, 95% CI = 1.15-1.23) and late quitting (OR = 1.24, 95% CI = 1.20-1.28). Varenicline prescription duration was not associated with smoking cessation among smokers who visited smoking clinics once. The relationship between varenicline prescription duration and smoking cessation was modified by the frequency of smoking clinic visits and was dependent on quitting process patterns. Encouraging smokers to continue visiting the smoking cessation clinic and use medication will help smoking cessation efforts in Taiwan.
虽然伐伦克林在随机临床试验中对戒烟有显著影响，但在真实世界环境中，伐伦克林治疗戒烟的剂量效应仍不清楚。本研究旨在评估在调整潜在混杂效应和内生性偏倚后，台湾地区伐伦克林处方持续时间与戒烟之间的关联。共有 5106 名台湾参与者在 2012 年 3 月至 2016 年 9 月期间接受伐伦克林单药治疗以戒烟。多分类逻辑回归（MLR）用于分析伐伦克林处方持续时间与戒烟之间的关联，按吸烟诊所就诊频率和戒烟治疗早期停药的倾向得分进行分层。与非戒烟组相比，伐伦克林处方持续时间较长与立即和完全戒烟（OR=1.08，95%CI=1.02-1.14）和延迟戒烟（OR=1.14，95%CI=1.07-1.20）的可能性更大相关。在那些更有可能继续就诊于吸烟诊所的患者中，较长时间使用伐伦克林与立即完全戒烟（OR=1.19，95%CI=1.15-1.23）和延迟戒烟（OR=1.24，95%CI=1.20-1.28）的可能性显著增加相关。就诊于吸烟诊所一次的吸烟者，伐伦克林处方持续时间与戒烟无关。伐伦克林处方持续时间与戒烟之间的关系受到吸烟诊所就诊频率的修饰，并取决于戒烟过程模式。鼓励吸烟者继续就诊于戒烟诊所并使用药物将有助于台湾的戒烟工作。
