Shade Agboola, Jo Leonardi-Bee, Ann McNeill and Tim Coleman
Presenter(s)
Shade Agboola Assistant Professor, Epidemiology and Public Health, University of Nottingham
Abstract
Introduction
There is evidence that varenicline increases the likelihood of long-term abstinence and reduces relapse following a quit attempt. Part of its benefit may arise from ‘recruiting into abstinence’ smokers who are not able to stop on the target quit date. This study aggregated data from the major varenicline RCTs to examine this issue.
Methods
Studies of varenicline compared with placebo in adult daily smokers with longest follow-up at either six or 12 months and with at least three follow-ups in the first month were included. Biochemically verified abstinence rates at each of six follow-up time points were pooled for studies reporting point prevalence abstinence and at three follow-up time periods were pooled for studies reporting continuous abstinence.
Results
Nineteen RCTs were included. Point-prevalence abstinence increased from week 2 (32%: 95% CI 25% - 40%) to week 12 (54%: 95% CI 48% - 61%) in the varenicline group compared with 16% (95% CI 11% - 21%) to 24% (95% CI 17% – 33%) in placebo.
Continuous abstinence in the varenicline group declined from 49% in weeks 9 to 12 (95% CI 45%-53%) to 22% (95% CI 19% -25%) by week 52 compared with 17% (95% CI 13% - 25%) in weeks 9 to 12 in the placebo group to 8% (95% 6% to 12%) by week 52.
Conclusions
Varenicline recruits smokers into abstinence following the target quit date to a greater extent than placebo. Smoking abstinence in smokers attempting to quit with varenicline is highest at 12 weeks after starting treatment.