Department of Behavioural Science and Health, University College London, London, UK.
SPECTRUM Consortium, Edinburgh, UK.
Addiction. 2024 Jul;119(7):1203-1210. doi: 10.1111/add.16485. Epub 2024 Apr 30.
Varenicline is one of the most effective smoking cessation treatments. Its supply in England was disrupted in July 2021 due to nitrosamine impurities found by its supplier, Pfizer. This study measured the impact of this disruption on smoking cessation in England.
DESIGN, SETTING AND PARTICIPANTS: The study used repeated cross-sectional surveys conducted monthly, from June 2018 to December 2022. Set in England, it comprised a total of 3024 adults who reported smoking during the past year and had made at least one serious attempt to quit in the past 6 months.
Generalized additive models analyzed the association of the varenicline supply disruption with the trend in self-reported varenicline use in the most recent quit attempt. We used these results to estimate the population-level impact of the disruption on smoking cessation.
Before July 2021, the proportion of past 6-month quit attempts using varenicline was stable at approximately 3.9% [risk ratio (RR) = 1.034, 95% confidence interval (CI) = 0.823-1.298]. The trend in varenicline use has changed sharply since the supply disruption (RR = 0.297, 95% CI = 0.120-0.738), with prevalence falling by 69.3% per year since; from 4.1% in June 2021 to 0.8% in December 2022. Convergently, National Health Service general practitioner prescribing data reported that just 0.1% of prescriptions for smoking cessation treatments in December 2022 were for varenicline. Assuming that varenicline does not return to the market, we estimate that this could result in ~8400 fewer people stopping smoking for at least 6 months, ~4200 fewer long-term ex-smokers and ~1890 more avoidable deaths each year.
In England, the disruption in supply of varenicline since 2021 has coincided with a substantial fall in the use of varenicline in attempts to quit smoking.
伐伦克林是最有效的戒烟治疗方法之一。由于其供应商辉瑞（Pfizer）发现亚硝胺杂质，其供应于 2021 年 7 月在英国中断。本研究旨在衡量这一中断对英国戒烟的影响。
设计、设置和参与者：该研究使用了从 2018 年 6 月至 2022 年 12 月每月进行的重复横断面调查。该研究在英格兰进行，共纳入 3024 名过去一年有吸烟史且在过去 6 个月内至少有一次认真戒烟尝试的成年人。
广义加性模型分析了伐伦克林供应中断与最近戒烟尝试中自我报告的伐伦克林使用趋势之间的关联。我们使用这些结果来估计供应中断对戒烟的人群水平影响。
在 2021 年 7 月之前，过去 6 个月使用伐伦克林的戒烟尝试比例稳定在 3.9%左右[风险比（RR）=1.034，95%置信区间（CI）=0.823-1.298]。自供应中断以来，伐伦克林的使用趋势发生了急剧变化（RR=0.297，95%CI=0.120-0.738），此后每年的流行率下降 69.3%；从 2021 年 6 月的 4.1%降至 2022 年 12 月的 0.8%。同时，国民保健制度（NHS）全科医生处方数据显示，2022 年 12 月用于戒烟治疗的处方中仅有 0.1%为伐伦克林。假设伐伦克林不再上市，我们估计这可能导致每年至少有 8400 人戒烟成功率下降，4200 名长期戒烟者减少，每年多 1890 人避免死亡。
在英国，自 2021 年以来伐伦克林供应中断与试图戒烟时伐伦克林使用量大幅下降同时发生。
