Combining Cessation Therapies Helps Highly Nicotine-dependent Males Quit Smoking

Among highly nicotine-dependent male smokers, therapies that combine smoking cessation agents significantly increase the likelihood of quitting, according to a study published in The American Journal of Psychiatry.

In a statement, the study authors said current smoking cessation aids, such as Chantix and Zyban, have yielded less-than-stellar results, with <25% of patients remaining abstinent after one year.

Jed Rose, PhD, and colleagues from Duke Medicine used a “randomized, double-blind, parallel-group adaptive treatment” in 222 cigarette smokers who failed to decrease their smoking levels by 50% through a one-week nicotine patch treatment.

Over a 12-week period, the participants received either a combination of varenicline and bupropion or a combination of varenicline and placebo. Treatment success was defined as “continuous smoking abstinence at weeks 8—11 after the target quit date,” the writers noted. Afterwards, the investigators sporadically followed up with participants over a 6-month period.

Compared to those prescribed varenicline and a placebo, patients taking bupropion and varenicline were more likely to stop smoking. Additionally, highly nicotine-dependent smokers benefitted from the combination treatment significantly more than those with lower levels of nicotine dependence. The researchers also noted a disparity between the success levels for male and female smokers.

According to Rose, the smoking abstinence rates among highly nicotine-dependent males increased from 14% for varenicline and placebo to 61% for varenicline and bupropion.

As a result of their findings, the authors recommended additional studies to further explore how gender and additional factors affect the likelihood of smoking cessation.

“While there may be some drawbacks to prescribing 2 smoking cessation treatments, such as cost or possible side effects, this study gives us a simple strategy to find those who would benefit the most from combined treatment, and spare others who may not benefit,” Rose said.