Quitting smoking before and after varenicline: a population study based on two representative samples of US smokers.
BACKGROUND
Varenicline is known to have greater efficacy than other pharmacotherapy for treating nicotine dependence and has gained popularity since its introduction in 2006. This study examines if adding varenicline to existing pharmacotherapies increased the population cessation rate.


METHODS
Data are from two cross-sectional US Current Population Surveys-Tobacco Use Supplements (2003 and 2010-2011). Smokers and recent quitters 18 or older (N=34 869 in 2003, N=27 751 in 2010-2011) were asked if they had used varenicline, bupropion or nicotine replacement therapies (NRT) in their most recent quit attempt. The annual cessation rate, as well as the per cent of smokers who had quit for ≥3 months, was compared between surveys.


RESULTS
Varenicline use increased from 0% in 2003 to 10.9% in 2010-2011, while use of bupropion decreased from 9.1% to 3.5%, and NRT from 24.5% to 22.4%. Use of any pharmacotherapy increased by 2.4 percentage points. Varenicline users stayed on cessation aids longer and were less likely to relapse than users of other pharmacotherapies in the first 3 months of a quit attempt, after which the difference was no longer significant. The change in annual cessation rate was negligible, from 4.5% in 2003 to 4.7% in 2010-2011 (p=0.36).


CONCLUSIONS
Addition of varenicline to the list of approved cessation aids has mainly led to displacement of other therapies. As a result, there was no meaningful change in population cessation rate despite a remarkable increase in varenicline use. The population impact of a new therapy is a function of more than efficacy or reach of the therapy.
['Zhu|Shu-Hong|SH|', 'Cummins|Sharon E|SE|', 'Gamst|Anthony C|AC|', 'Wong|Shiushing|S|', 'Ikeda|Tyson|T|']
D000293:Adolescent D000328:Adult D000368:Aged D016642:Bupropion D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D018722:Nicotinic Agonists D012008:Recurrence D000074285:Smokers D016540:Smoking Cessation D011795:Surveys and Questionnaires D013997:Time Factors D061485:Tobacco Use Cessation Devices D014029:Tobacco Use Disorder D014481:United States D000068580:Varenicline D055815:Young Adult
Nicotine Cessation Health Services