In a randomized, double-blind, parallel-group adaptive treatment trial, researchers in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center identified 222 cigarette smokers who failed to show a reduction of more than 50 percent in smoking after one week of nicotine-patch treatment. Smokers were randomly assigned to receive 12 weeks of varenicline plus bupropion or varenicline plus placebo. The primary outcome measure was continuous smoking abstinence at weeks 8 to 11 after the target quit date.
Participants who received the combination treatment had a significantly higher abstinence rate than those who received varenicline plus placebo. Combination treatment had a significantly greater effect on abstinence rates of male smokers than female smokers. It also had a significantly greater effect in highly nicotine-dependent smokers than in smokers with lower levels of dependence.
“In addition to showing superior efficacy of combination treatment in specific subpopulations of smokers, our results further validate an adaptive treatment model, in which smokers receive a week of prequit nicotine-patch treatment, and, based on their reduction in ad lib smoking, either remain on the patch or receive adaptive modifications of treatment,” the authors wrote.
For more information, see the Psychiatric News article, “Smoking Cessation for Patients Called an Urgent Priority.”