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The effect of varenicline and nicotine patch on smoking rate and satisfaction with smoking: an examination of the mechanism of action of two pre-quit pharmacotherapies

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Abstract

Objectives

In recent years, there has been growing research interest in using nicotine replacement medications to aid smoking reduction prior to a quit attempt. Gaining a better understanding of how treatments influence smoking reduction may allow for better tailoring of treatments and, ultimately, better cessation outcomes. The objective of the current study was to test the effects of the pre-quit use of varenicline and nicotine patch on smoking rate and satisfaction with smoking.

Methods

All participants were required to attend up to five study visit sections. Participants (n = 213) who were interested in quitting were randomised (open-label) to receive either pre-quit patch or varenicline (both treatments started 2 weeks prior to an assigned quit day, followed by 10 weeks post-quit) or standard patch (10 weeks starting from an assigned quit day). Participants used modified smartphones to monitor their smoking in real time for 4 weeks.

Results

Participants in the two pre-quit treatment groups reported significant reductions in both their satisfaction with smoking (p < 0.001) and smoking rate (p < 0.001) from baseline to the end of pre-quit period; participants in the standard patch group did not. The observed reduction of smoking rate was associated with the satisfaction with smoking (p < 0.01), although the mediation effect of satisfaction was small.

Conclusions

Pre-quit treatment caused reductions in satisfaction with smoking and smoking rate. Satisfaction was associated with changes in smoking rate, but the relationship was weak. As such, monitoring reductions in satisfaction do not appear to be a viable method of evaluating responsiveness to treatment.

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Acknowledgements

This project was supported by a researcher-initiated project grant from Pfizer (through the GRAND initiative) awarded to SGF. Additional funding was provided by the Royal Hobart Hospital Research Foundation (awarded to SGF). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of Pfizer of the Royal Hobart Hospital Research Foundation. The trial sponsor, the University of Tasmania, is gratefully acknowledged.

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Authors and Affiliations

  1. School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia

    Wenying Lu, Julia A. E. Walters, Glenn A. Jacobson & Rahul Patel

  2. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia

    Kate Chappell

  3. School of Health Science, University of Tasmania, Hobart, Australia

    Natalie Schüz

  4. School of Medicine, University of Tasmania, Private Bag 34, Hobart, TAS, 7001, Australia

    Stuart G. Ferguson

Authors
  1. Wenying Lu
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  2. Kate Chappell
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  3. Julia A. E. Walters
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  4. Glenn A. Jacobson
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  5. Rahul Patel
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  6. Natalie Schüz
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  7. Stuart G. Ferguson
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Correspondence to Stuart G. Ferguson.

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Conflict of interest

Dr. Ferguson has worked as a consultant to GlaxoSmithKline Consumer Healthcare and Chrono Therapeutics on matters relating to smoking cessation, has received researcher-initiated project grant funding from Pfizer (through the GRAND initiative) and has served on an advisory board for Johnson & Johnson. The other authors have nothing to declare.

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Lu, W., Chappell, K., Walters, J.A.E. et al. The effect of varenicline and nicotine patch on smoking rate and satisfaction with smoking: an examination of the mechanism of action of two pre-quit pharmacotherapies. Psychopharmacology 234, 1969–1976 (2017). https://doi.org/10.1007/s00213-017-4604-y

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