ADDICTION
July 28, 2014

A One-Two Punch Against Smoking

If you’ve tried to quit before, the nicotine patch and medication together may do the trick.

For people who have tried to quit smoking and keep slipping back, here’s some good news: A new study finds that smokers who use the medication varenicline (known best by its brand name, Chantix®) along with a nicotine patch have a much higher success rate than people who use just the medication alone.

Though Chantix®) may not be a first line of treatment, if you’ve tried to quit in the past, this may be something for you and your doctor to consider.

Four hundred and fifty otherwise healthy smokers used either the nicotine patch or a placebo patch for 12 weeks prior to their target quit date. The placebo patch looked just like the real nicotine patch, but didn’t deliver any nicotine.

At six months out 65% of people who’d had the nicotine patch were still not smoking, compared to 47% of people with the placebo patch.

One week before the target quit date, all of the participants also started taking the medication varenicline that acts on sites in the brain affected by nicotine. They continued taking it for another 12 weeks. During the 13th week, they tapered off the drug.

People who’d gotten the real nicotine patch along with the medication were more likely at the 12-week mark to be cigarette-free: 55% of people in this group had quit smoking vs. 41% in the placebo patch group. (Remember that everyone in the study took the medication varenicline.)

At 24 weeks, half of the people in the nicotine patch group had quit vs. a third of those in the placebo patch group. At six months out, the difference was still there: 65% of people who’d had the nicotine patch were still not smoking, compared to 47% of people with the placebo patch.

The results are encouraging, since they suggest that combining treatments has a much greater effect on quitting than just one treatment alone.

There were some side effects, however: People who’d had both the nicotine patch and the medication reported more nausea, sleep problems, skin reactions, constipation, and depression. Those in the medication-only group (i.e., those who’d had the placebo patch) had more headaches and abnormal dreams.

It’s important to point out that varenicline does carry a black box warning because of an increased risk of suicide, and some research has suggested that it shouldn’t be used as a first line of treatment.

Since quitting smoking is linked not only to better health, but to notable improvements in happiness, satisfaction, and quality of life, consider doing it now.

If you’ve tried unsuccessfully to quit in the past, speak with your doctor about different methods. Smoking is a notoriously tough habit to kick, and it can take a number of tries. But there are more and more helpful methods out there: Some states offer free smoking cessation help, including nicotine patches and phone helplines.

Text messaging programs have also been found to be an effective tool for people to use while quitting.

The research was carried out at Stellenbosch University in Cape Town, South Africa, and published in the Journal of the American Medical Association.

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