(RxWiki News) A cigarette habit can be hard to kick, especially for people with serious mental illnesses. Luckily, there's a medication that might make the quitting process easier.
A recent study found that tobacco smokers with a serious mental illness were significantly more likely to abstain from smoking for long periods of time with regular use of varenicline (brand name Chantix) in conjunction with continual cognitive behavioral therapy, compared to just therapy on its own.
The researchers believe that using medicine plus therapy could help reduce the high level of tobacco dependence among mentally ill patients and thus reduce the health-related problems and death in this population.
"Tell a doctor if you have a dependency on tobacco."
The lead author of this study was A. Eden Evins, MD, MPH, from Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts.
The study included 87 patients who were enrolled in outpatient programs at one of 10 community health centers in Massachusetts, Michigan, New Hampshire, Indiana, Alabama and Minnesota between March 2008 and April 2012.
A total of 77 participants had schizophrenia, and 10 participants had bipolar disorder.
Ages of participants ranged from 22 to 66 years old.
Each participant smoked 10 or more cigarettes per day for at least a year leading up to the study, but agreed to try to stop smoking within four weeks of enrolling in the study.
The researchers gave each participant 0.5 mg of varenicline for the first three days of the study, then 0.05 mg twice a day for four days and then 1.0 mg twice a day for four weeks.
Participants attended 12 weekly, one-hour group cognitive behavioral therapy sessions, and were asked to quit smoking between study weeks four and five.
After not smoking at all for two weeks by study week 12, the participants were randomly assigned to two groups, with 40 participants taking 1.0 mg of varenicline per day and 47 taking a placebo (fake). This lasted from study weeks 12 to 52.
All participants remained in cognitive behavioral therapy throughout the whole study.
The researchers then discontinued study treatment for the participants at week 52 and conducted a follow-up at week 76.
The findings showed that 24 of the 40 participants in the varenicline group (60 percent) had stopped smoking for at least seven consecutive days, compared to nine of the 47 participants (19 percent) in the placebo group.
The participants in the varenicline group were 6.2 times more likely to have stopped smoking for seven days by week 52 compared to the placebo group.
By week 64, 18 participants in the varenicline group (45 percent) had achieved abstinence for seven days straight, compared to six participants (13 percent) in the placebo group.
The researchers determined that the participants in the varenicline group were 5.1 times more likely than the placebo group to have achieved abstinence for seven consecutive days by week 64.
From weeks 12 to 52, 18 participants in the varenicline group (45 percent) and seven of the placebo group (15 percent) had quit smoking for the entire time.
Compared to the placebo group, the varenicline group had 4.6 times increased odds of achieving continual and consecutive abstinence from smoking for the whole time period between weeks 12 and 52.
The researchers discovered that 16 of the varenicline group (40 percent) had been able to continually stop smoking the whole time from week 12 to 64 versus only five participants (11 percent) in the placebo group.
The varenicline group had 5.2 times increased odds of not smoking between weeks 12 and 64 compared to the placebo group.
By week 76 — when the researchers conducted a follow-up — 12 participants of the varenicline group (30 percent) had quit smoking for the full 16 months, compared to five participants (11 percent) in the placebo group.
At the end of the study, it was determined that the varenicline group was 3.4 times more likely than the placebo group to have achieved abstinence from smoking for 16 months.
Lastly, the findings showed that the average relapse time for the participants in the varenicline group was 358 days versus 35 days for those in the placebo group.
The authors noted a couple limitations of their study. First, the study population was small. Second, some of the participants dropped out before the end of the study.
This study was published on January 7 in JAMA.
The National Institute on Drug Abuse and Pfizer provided funding.
