Study Points to More Effective Smoking-Cessation Treatment

Researchers appear to have identified a strategy to "rescue" a significant proportion of smokers whose attempts to quit using a nicotine patch alone failed, according to a report in the August American Journal of Psychiatry (AJP). Jed Rose, Ph.D., and Frederique Behm, C.R.A., of Duke University's Department of Psychiatry and Behavioral Sciences, initiated nicotine-patch treatment in 606 subjects two weeks before an agreed-upon quit date. Subjects who did not decrease their smoking by at least 50% on the patch were randomly assigned to one of three conditions—continuing on the patch, the patch plus bupropion, or the patch plus the smoking-cessation drug varenicline.

Results showed a significant benefit at the end of treatment for the patch plus bupropion group, and a less robust effect for the patch plus varenicline—from the quit date to week 11, 16% were abstinent on the patch alone, 28% on bupropion, and 23% on varenicline. Rose and Behm concluded that their findings show "It is possible to rescue a significant portion of smokers who would have failed to achieve abstinence if left on the nicotine patch alone by identifying these smokers before their quit date and implementing adaptive changes in treatment."

In an accompanying editorial, AJP Editor-in-Chief Robert Freedman, M.D., called the study "a remarkable first attempt to improve smoking cessation by selecting treatment...based on an initial test period." He did note, however, that, "Although many patients in this study were helped, most had returned to smoking at 6 months, which points out the recalcitrance of this addiction to remediation."

To read more on smoking-cessation research, see Psychiatric News here and here.

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