Varenicline along with psychotherapy effective option for smoking cessation in daily smokers: JAMA

USA: A new study conducted by Lisa Sanderson Cox and the team showed that varenicline combined with counseling increased the rates of 7-day point prevalence smoking abstinence among African American adults who smoke on a daily basis at week 26. The findings of this study were published in The Journal of American Medical Association.

Effective therapy is required for all levels of smoking since African Americans have some of the highest rates of tobacco-related morbidity and mortality in the US. In order to compare the effectiveness of varenicline with placebo among African American people who smoke light, moderate, and heavy cigarettes per day, this study was carried out.

At a Kansas City federally qualified health center, the Kick It at Swope IV (KIS-IV) trial was a randomized, double-blind, placebo-controlled clinical study. From June 2015 to December 2017, 500 African American adults of all smoking ages were enrolled; the last follow-up was finished in June 2018. Before being randomly assigned to receive varenicline (1 mg twice daily; n = 300) or a placebo (n = 200) for 12 weeks, participants underwent six sessions of culturally appropriate individual therapy. By sex and level of smoking, randomization was stratified.

The main result was a 7-day point prevalence of smoking cessation measured by salivary cotinine at week 26. With subgroup analyses for light smokers (10 cigarettes per day) and moderate to heavy smokers (>10 cigarettes per day), the secondary outcome was the 7-day point prevalence of smoking abstinence at week 12.

The key findings of this study were as follows:

1. 441 (88%) of the 500 randomized participants underwent the baseline visit and finished the trial.

2. Participants receiving varenicline were considerably more likely than those taking a placebo to be abstinent at week 26 when those lost to follow-up were considered to be smokers.

3. At the conclusion of therapy week 12, the varenicline group additionally displayed stronger abstinence than the placebo group.

4. With no discernible smoking level treatment interaction at week 12, smoking abstinence was considerably higher for those taking varenicline compared to placebo in both light and moderate to heavy smokers.

5. The frequency of nausea reports was higher in the varenicline group, but overall, adverse drug reactions were equivalent across treatment groups.

In conclusion, the results of this study support the use of varenicline along with psychotherapy for treating tobacco use in African American adults who smoke regularly.

Reference:

Cox, L. S., Nollen, N. L., Mayo, M. S., Faseru, B., Greiner, A., Ellerbeck, E. F., Krebill, R., Tyndale, R. F., Benowitz, N. L., & Ahluwalia, J. S. (2022). Effect of Varenicline Added to Counseling on Smoking Cessation Among African American Daily Smokers. In JAMA (Vol. 327, Issue 22, p. 2201). American Medical Association (AMA). https://doi.org/10.1001/jama.2022.8274