Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation

Smoking tobacco is a widespread problem throughout the world, and there have been many attempts to create pharmacotherapies for smoking cessation. A study in the Journal of the American Medical Association compared traditional nicotine replacement therapy (NRT), varenicline, and a combination nicotine replacement therapy (C-NRT) in 1086 smokers. The difference in abstinence rates between the NRT patch and the other two therapies were not considered to be significant. It was also found that those in the C-NRT and varenicline groups had significantly lower withdrawal ratings than those just using the patch. The authors mention some problems the study could have faced, including low adherence to the therapies, length of the study, and also it being an open-label study where the patients knew what they were taking.

With how common smoking is, studies revolving around smoking cessation is important. While this study may have some flaws, it illustrates that all these three therapies have an effect on motivating smokers to quit smoking. If the non-prescription patch is as effective as the other two prescription therapies, it can greatly influence some smokers’ decisions about trying to quit smoking. The patch will be a lot cheaper and accessible, thus be able to reach a larger population. A big problem the study pointed out that is also common in other smoking cessation studies is the somewhat low adherence, rates being a little below 50%. In the smokers that did adhere, results could be seen from the lower amount of cigarettes they smoked or even completely quitting. Quitting smoking will greatly improve the health of a person, and these pharmacotherapies can help one with the process.

JAMA. 2016;315(4):371-379.

1 thought on “Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation”

  1. I really enjoyed reading this article because it relates directly to a patient experience my group and I had just the other day. The patient was a smoker that had quit for 18 years and recently started up again. She asked if we had any recommendations to help her quit again, and we were unsure of what to tell her. We told her about the patch, the gum and various prescriptions available for smoking rescission. We were more familiar with the patch but she told us the patch gives her bad cravings immediately upon removal of the patch. The topic of smoking is a difficult one because it is like asking a drug addict to stop using. I feel as though pharmacists can play a huge role in helping patients quit smoking because they can educate them on adherence and the various ways a patient can go about quitting smoking. Pharmacists can guide a patient’s therapy, meaning if one method does not work a pharmacist can counsel and educate a patient on another method that may be more effective for that patient. All this can happen by simply stopping into the pharmacy; a doctor’s appointment is not necessary for a patient attempting to quit smoking.

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