Extending the duration of prequit treatment with varenicline does not improve smoking quit rate

Référence

Hawk LW Jr, Tiffany ST, Colder CR, et al. Effect of extending the duration of prequit treatment with varenicline on smoking abstinence. A randomized clinical trial. JAMA Network Open 2022;5(11):e2241731.

Sommaire

Extending the prequit period of varenicline treatment may enhance successful smoking cessation by having additional time to affect nicotinic receptors and extinguish the desire to smoke. These investigators recruited via advertisements adult smokers, aged 18 to 70 years, who smoked 10 or more cigarettes per day for at least 6 months and were motivated to quit smoking. Eligible participants (N = 320) randomly received (concealed allocation assignment) a 4-week standard tapering dose of varenicline (extended run-in group) or 3 weeks of placebo and 1 week of the standard varenicline loading dose (standard run-in group). Beginning on the quit date, all participants received open-label 1.0 mg varenicline twice daily for weeks 5 to 15 and, at each check-in visit, a brief (15-minute) behavioral counseling session on successful smoking cessation techniques. All participants were instructed to smoke as usual during weeks 1 to 3 prior to quitting. Individuals masked to treatment group assignment validated self-reported quit rates using cotinine saliva levels. Complete follow-up occurred for 76% of participants at 6 months. Using intention-to-treat analysis, no significant differences occurred in continuous abstinence from smoking between the extended run-in group and the standard run-in group at 3 months (39.3% vs 36.3%) and 6 months (22% vs 19%). Results did not differ significantly between self-identified women and men.