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.

Mailing Nicotine Patches to Aid in Smoking Cessation

This past July, a randomized clinical trial just concluded after nearly three years of study which evaluated whether or not mailing nicotine patches to adult smokers without behavioral support would help increase quit success rates. The trial included 2,093 individuals who smoked more than 10 cigarettes daily. Individuals who were interested and eligible to participate were designated to either an experimental group that received a 5-week supply of nicotine patches by mail or a control group that offered any other form of intervention. The individuals were followed-up with by the investigators at 8 weeks and at 6 months.

After the study, self-reported assistance rates were significantly higher for those in the experimental group who received nicotine replacement therapy via mail compared to those in the control group. Overall, the trial provided evidence that mailed nicotine patches were effective to promote successful tobacco cessation. However, because of the lack of biochemical validation for all the individuals in the study, the strength of these findings is somewhat tempered.

JAMA Intern Med. Published online January 25, 2016.

Link to article

This article came of interest to me because it brought to my attention how increased access to healthcare can lead to an overall healthier lifestyle. Like with available mailing services, more and more patients will be able to obtain the healthcare that they need as pharmacists move to provider status. I personally am looking forward to the future of healthcare that leads to a better well-being amongst the community.