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Cited by 31Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesChronic Obstructive Pulmonary Disease (COPD) Research

Smoking cessation-recent advances

McNeil, John J., Piccenna, Loretta, Ioannides-Demos, Lisa L.·2010·Cardiovascular Drugs and Therapy
DOI 10.1007/s10557-010-6246-8
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Abstract

Background Smoking continues to be a major contributor to the burden of disease across the world although there has been a decrease in some developed countries such as USA and Australia. In countries of South-East Asia with a high prevalence of smoking, the incidence of tobacco-related diseases will continue to increase.Methods We reviewed the literature in relation to the pharmacology of nicotine, the measures used to determine the efficacy of anti-smoking therapies, and the randomised controlled trials and systematic reviews of pharmacotherapies published between 2004 and 2010. We focused primarily on the three first line therapies that are currently available: nicotine replacement therapy (NRT), bupropion and varenicline.Results Randomised controlled trials and meta-analyses have demonstrated that single therapy with either NRT, bupropion or varenicline are all more effective than placebo for smoking cessation. Abstinence rates for monotherapies varies from 13.3% to 19% for NRT compared to 7.5% to 14% for placebo, 19% to 19.7% for bupropion versus 10.9% to 11% for placebo and 25.5% to 25.6% for varenicline versus 11.2% to 14.8% for placebo. Of current therapies varenicline appears to be more effective at achieving abstinence. Some combination therapies with one or two formulations of NRT or NRT plus bupropion have demonstrated superior results to monotherapy. To date there are no randomised controlled trials of varenicline in combination with NRT or bupropion.Conclusion Further studies are required to address the uncertainty that exists on the most appropriate duration of therapy as well as the effectiveness and safety of combination pharmacotherapy. Post-marketing surveillance continues to play an important role in monitoring the adverse effects events associated with these therapies.

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  • 21-23% of patients taking varenicline for 12 weeks maintained abstinence at 52 weeks.

    “Nearly one quarter (21–23%) of patients taking varenicline for a short period of time (12 weeks) maintained abstinence at 52 weeks of follow-up.”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [233]

  • Negative affect and craving associated with abstinence are decreased in patients taking varenicline relative to placebo.

    “negative affect and craving associated with abstinence were decreased in patients taking varenicline relative to placebo [233].”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [233]

  • Two large randomized placebo-controlled studies in 2006 compared varenicline efficacy to bupropion in aided smoking cessation.

    “Two large, randomized, placebo-controlled studies released in 2006 related the efficacy of varenicline to that of bupropion in aided smoking cessation [233, 241].”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [233]

  • Varenicline has no significant effect on restlessness, insomnia, or increased appetite.

    “However, the drug had no significant effect on restlessness, insomnia, or increased appetite.”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [233]

  • Combining bupropion with NRT augments abstinence rates to 29%.

    “which are further augmented to 29% when the drug is combined with NRT [210, 234, 235].”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [234]

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Authors
McNeil, J. J., Piccenna, L., & Ioannides-Demos, L. L.
Affiliations
The Alfred Hospital (AU)
Corresponding author
McNeil, John J.
ORCID
Venue
Cardiovascular Drugs and Therapy
Publisher
Springer Science and Business Media LLC
Published
2010-07-03
Volume
24
Issue
4
Pages
359-367
ISSN
  • 0920-3206 (ISSN-L)
  • 1573-7241
DOI
10.1007/s10557-010-6246-8
OpenAlex
W1972797504
Cited by
31
References
52
Citations by year
2022: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 6 · 2012: 11
FWCI
0.64
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Cardiovascular Drugs and Therapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords
smoking cessation, nicotine replacement therapy, bupropion, varenicline, nicotine pharmacology, combination pharmacotherapy, smoking-related diseases, post-marketing surveillance
MeSH terms
Varenicline, Australia, Benzazepines, Cardiovascular Diseases, Drug Therapy, Combination, United Kingdom, Humans, Nicotine, Quinoxalines, Smoking, Substance Withdrawal Syndrome, United States, Randomized Controlled Trials as Topic, Immunotherapy, Active, Smoking Cessation, Bupropion, Treatment Outcome, Nicotinic Agonists, Dopamine Uptake Inhibitors, Transdermal Patch

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