Improvement of Smoking Abstinence Rates with Increased Varenicline Dosage

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Abstract

Purpose/Background It is unclear whether increasing the dose of varenicline beyond the standard dose of 2 mg/d would improve smoking abstinence. Methods We examined the effect of 3 mg/d of varenicline on smoking abstinence among smokers who had reduced their smoking by 50% or more in response to 2 mg/d for at least 6 weeks but had not quit smoking. Of 2833 patients treated with varenicline, dosage of a subset of 73 smokers was increased to 3 mg/d after 6 weeks. We used a propensity score analysis involving multiple baseline covariates to create a comparative sample of 356 smokers who remained on 2 mg/d. All smokers received concurrent and similar smoking-cessation counseling. Results At 3 months, we found higher 7-day point prevalence smoking-abstinence rate in the 3-mg group (26%) than in the 2-mg group (11.5%, χ 2 = 10.60, P < 0.001; risk ratio [RR], 2.3; 95% confidence interval [CI], 1.4-3.6). The difference in abstinence rates remained significant at the 6-month (P < 0.001; RR, 2.6; 95% CI, 1.6-3.9) and 9-month follow-up (P < 0.001; RR, 2.2; 95% CI, 1.4-3.3). Conclusions A relatively small increase in the daily dose of varenicline seems to offer a benefit for those who are not able to achieve total abstinence after approximately 6 weeks of 2 mg/d.

Original languageEnglish (US)
Pages (from-to)34-41
Number of pages8
JournalJournal of Clinical Psychopharmacology
Volume38
Issue number1
DOIs
StatePublished - Feb 1 2018

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Smoking
Odds Ratio
Confidence Intervals
Propensity Score
Smoking Cessation
Counseling
Varenicline

Keywords

  • 3 mg varenicline
  • cancer
  • high dose
  • smoking abstinence

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

@article{84067b50fffe4e32b3f531f1fa4f9eb3,
title = "Improvement of Smoking Abstinence Rates with Increased Varenicline Dosage",
abstract = "Purpose/Background It is unclear whether increasing the dose of varenicline beyond the standard dose of 2 mg/d would improve smoking abstinence. Methods We examined the effect of 3 mg/d of varenicline on smoking abstinence among smokers who had reduced their smoking by 50{\%} or more in response to 2 mg/d for at least 6 weeks but had not quit smoking. Of 2833 patients treated with varenicline, dosage of a subset of 73 smokers was increased to 3 mg/d after 6 weeks. We used a propensity score analysis involving multiple baseline covariates to create a comparative sample of 356 smokers who remained on 2 mg/d. All smokers received concurrent and similar smoking-cessation counseling. Results At 3 months, we found higher 7-day point prevalence smoking-abstinence rate in the 3-mg group (26{\%}) than in the 2-mg group (11.5{\%}, χ 2 = 10.60, P < 0.001; risk ratio [RR], 2.3; 95{\%} confidence interval [CI], 1.4-3.6). The difference in abstinence rates remained significant at the 6-month (P < 0.001; RR, 2.6; 95{\%} CI, 1.6-3.9) and 9-month follow-up (P < 0.001; RR, 2.2; 95{\%} CI, 1.4-3.3). Conclusions A relatively small increase in the daily dose of varenicline seems to offer a benefit for those who are not able to achieve total abstinence after approximately 6 weeks of 2 mg/d.",
keywords = "3 mg varenicline, cancer, high dose, smoking abstinence",
author = "Maher Karam-Hage and George Kypriotakis and Robinson, {Jason D.} and Green, {Charles E.} and Gurtej Mann and Vance Rabius and Rosario Wippold and Blalock, {Janice A.} and Elie Mouhayar and Jean Tayar and Patrick Chaftari and Cinciripini, {Paul M.}",
year = "2018",
month = "2",
day = "1",
doi = "10.1097/JCP.0000000000000829",
language = "English (US)",
volume = "38",
pages = "34--41",
journal = "Journal of Clinical Psychopharmacology",
issn = "0271-0749",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Improvement of Smoking Abstinence Rates with Increased Varenicline Dosage

AU - Karam-Hage, Maher

AU - Kypriotakis, George

AU - Robinson, Jason D.

AU - Green, Charles E.

AU - Mann, Gurtej

AU - Rabius, Vance

AU - Wippold, Rosario

AU - Blalock, Janice A.

AU - Mouhayar, Elie

AU - Tayar, Jean

AU - Chaftari, Patrick

AU - Cinciripini, Paul M.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Purpose/Background It is unclear whether increasing the dose of varenicline beyond the standard dose of 2 mg/d would improve smoking abstinence. Methods We examined the effect of 3 mg/d of varenicline on smoking abstinence among smokers who had reduced their smoking by 50% or more in response to 2 mg/d for at least 6 weeks but had not quit smoking. Of 2833 patients treated with varenicline, dosage of a subset of 73 smokers was increased to 3 mg/d after 6 weeks. We used a propensity score analysis involving multiple baseline covariates to create a comparative sample of 356 smokers who remained on 2 mg/d. All smokers received concurrent and similar smoking-cessation counseling. Results At 3 months, we found higher 7-day point prevalence smoking-abstinence rate in the 3-mg group (26%) than in the 2-mg group (11.5%, χ 2 = 10.60, P < 0.001; risk ratio [RR], 2.3; 95% confidence interval [CI], 1.4-3.6). The difference in abstinence rates remained significant at the 6-month (P < 0.001; RR, 2.6; 95% CI, 1.6-3.9) and 9-month follow-up (P < 0.001; RR, 2.2; 95% CI, 1.4-3.3). Conclusions A relatively small increase in the daily dose of varenicline seems to offer a benefit for those who are not able to achieve total abstinence after approximately 6 weeks of 2 mg/d.

AB - Purpose/Background It is unclear whether increasing the dose of varenicline beyond the standard dose of 2 mg/d would improve smoking abstinence. Methods We examined the effect of 3 mg/d of varenicline on smoking abstinence among smokers who had reduced their smoking by 50% or more in response to 2 mg/d for at least 6 weeks but had not quit smoking. Of 2833 patients treated with varenicline, dosage of a subset of 73 smokers was increased to 3 mg/d after 6 weeks. We used a propensity score analysis involving multiple baseline covariates to create a comparative sample of 356 smokers who remained on 2 mg/d. All smokers received concurrent and similar smoking-cessation counseling. Results At 3 months, we found higher 7-day point prevalence smoking-abstinence rate in the 3-mg group (26%) than in the 2-mg group (11.5%, χ 2 = 10.60, P < 0.001; risk ratio [RR], 2.3; 95% confidence interval [CI], 1.4-3.6). The difference in abstinence rates remained significant at the 6-month (P < 0.001; RR, 2.6; 95% CI, 1.6-3.9) and 9-month follow-up (P < 0.001; RR, 2.2; 95% CI, 1.4-3.3). Conclusions A relatively small increase in the daily dose of varenicline seems to offer a benefit for those who are not able to achieve total abstinence after approximately 6 weeks of 2 mg/d.

KW - 3 mg varenicline

KW - cancer

KW - high dose

KW - smoking abstinence

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U2 - 10.1097/JCP.0000000000000829

DO - 10.1097/JCP.0000000000000829

M3 - Article

C2 - 29232312

AN - SCOPUS:85040329959

VL - 38

SP - 34

EP - 41

JO - Journal of Clinical Psychopharmacology

JF - Journal of Clinical Psychopharmacology

SN - 0271-0749

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